Serum Dickkopf-1 levels and poststroke depression in ischemic stroke patients
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Published on: May 22, 2019
Kaixin Zhang1, Zhengbao Zhu1, Mengyao Shi2
1Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Insights
Higher serum Dickkopf-1 (Dkk-1) levels are linked to an increased risk of poststroke depression (PSD) within three months. This finding suggests Dkk-1 may serve as a prognostic biomarker for PSD after ischemic stroke.
Area of Science:
- Neuroscience
- Biomarkers
- Stroke Research
Background:
- Serum Dickkopf-1 (Dkk-1) levels are linked to poor ischemic stroke prognosis.
- The association between Dkk-1 and poststroke depression (PSD) is not well understood.
Purpose of the Study:
- To investigate the relationship between serum Dkk-1 levels and the occurrence of PSD.
- To determine if Dkk-1 can serve as a prognostic biomarker for PSD.
Main Methods:
- Serum Dkk-1 levels were measured in 564 ischemic stroke patients from the CATIS trial.
- Depression status was assessed at 3 months post-stroke using the Hamilton Rating Scale for Depression (HRSD-24), with a cutoff of ≥8.
- Statistical analyses, including multivariable regression, were performed to adjust for confounders.
Main Results:
- 224 patients (39.72%) developed PSD at 3 months.
- Elevated Dkk-1 levels were significantly associated with an increased risk of PSD (OR, 1.92; 95% CI, 1.14-3.22; Ptrend=0.037).
- Each SD increase in log-transformed Dkk-1 levels correlated with a 24% increased risk of PSD (OR, 1.24; 95% CI, 1.03-1.49; P=0.025).
Conclusions:
- Higher baseline serum Dkk-1 levels are independently associated with a greater risk of developing PSD.
- Serum Dkk-1 may be a valuable prognostic biomarker for identifying patients at risk of PSD after ischemic stroke.
Background:
Serum Dickkopf-1 (Dkk-1) levels are associated with poor ischemic stroke prognosis, although their impact on poststroke depression (PSD) remains unclear. This study aimed to examine the association between serum Dkk-1 levels and PSD.
Methods:
Serum Dkk-1 levels were measured in 564 patients with ischemic stroke who participated in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The patients' depression status at 3 months after stroke was assessed using the Hamilton Rating Scale for Depression (HRSD-24). The HRSD score cutoff point for the diagnosis of depression was ≥8.
Results:
A total of 224 (39.72%) patients were categorized as having PSD 3 months after ischemic stroke. After adjusting for potential confounders, including age, sex, and other important covariates, elevated Dkk-1 levels were associated with an increased risk of PSD (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.14-3.22; Ptrend = 0.037). Similarly, each standard deviation (SD) increase in log-transformed Dkk-1 levels was associated with a 24% increased risk of PSD (OR, 1.24; 95% CI, 1.03-1.49; P = 0.025). Subgroup analyses further confirmed the significant associations between Dkk-1 levels and PSD.
Conclusion:
Higher serum Dkk-1 levels at baseline are independently associated with an increased risk of PSD at 3 months after stroke, suggesting that Dkk-1 levels may be a promising prognostic biomarker for PSD.
Limitations:
This study measured serum Dkk-1 levels only in the acute phase of stroke not in different phases; therefore, the relationship between dynamic changes in Dkk-1 levels and PSD could not be evaluated.
