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Glyoxal in hyperglycaemic ischemic stroke - a cohort study
Sina Rhein1,2, Julica Inderhees1,2,3, Oliver Herrmann4
1Institute for Experimental and Clinical Pharmacology and Toxicology, Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany.
High glucose levels in acute ischemic stroke are linked to poor outcomes. Reactive glucose metabolites, glyoxal and methylglyoxal, are associated with worse stroke prognosis, suggesting they may be therapeutic targets.
Area of Science:
- Biochemistry
- Neurology
- Metabolic Disorders
Background:
- Hyperglycemia is common in acute ischemic stroke and predicts poor prognosis, even without diabetes.
- Insulin therapy for hyperglycemia has not improved stroke outcomes, suggesting indirect harmful effects.
- Reactive glucose metabolites like glyoxal and methylglyoxal are implicated in hyperglycemia's detrimental effects on ischemic brain injury.
Purpose of the Study:
- To investigate the association between serum concentrations of glyoxal, methylglyoxal, and their derivatives with stroke outcomes.
- To identify potential biomarkers for predicting stroke prognosis in hyperglycemic patients.
Main Methods:
- Serum samples from 135 acute stroke patients were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
- Measurements included glyoxal, methylglyoxal, and specific glycated amino acid derivatives.
- Results were validated in a second cohort of 61 stroke patients and correlated with stroke outcome scales (NIHSS, mRS).
Main Results:
- Elevated levels of glucose, glyoxal, methylglyoxal, and the glyoxal-derived Nδ-(5-hydro-4-imidazolon-2-yl)ornithine (G-H1) correlated with poor stroke outcomes (mRS90) at 3 months.
- Patients with poor outcomes exhibited higher serum concentrations of glyoxal and methylglyoxal.
- Some glycated amino acids (CEL, pyrraline) showed inverse correlations, possibly due to reduced food intake in severe stroke.
Conclusions:
- Glucose-derived α-dicarbonyls, specifically glyoxal and its related glycated amino acids, are linked to poor outcomes in ischemic stroke.
- Targeting these α-dicarbonyls or mitigating their effects may offer a therapeutic strategy for managing hyperglycemic stroke.
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