The Combination of Insulin Resistance and Serum Interleukin-1β Correlates with Post-Stroke Depression in Patients with Acute Ischemic Stroke
Authors Yi X, Zhu X, Zhou Y, Zhang D, Li M, Zhu Y, Guo X
Received 9 November 2020
Accepted for publication 7 February 2021
Published 9 March 2021 Volume 2021:17 Pages 735—746
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Yuping Ning
Xiaoyi Yi,1 Xiangyang Zhu,1 Yong Zhou,1 Dongmei Zhang,2 Mengmeng Li,2 Yuting Zhu,1 Xiaoming Guo1
1Deparment of Neurology, Affiliated Hospital 2 of Nantong University, Nantong, People’s Republic of China; 2Clinical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, People’s Republic of China
Correspondence: Xiangyang Zhu
Department of Neurology, Affiliated Hospital 2 of Nantong University, 6 Haier-Xiang North Road, Nantong, 226000, Jiangsu, People’s Republic of China
Fax +86 513-85061148
Email [email protected]
Purpose: Previous studies have shown that insulin resistance and inflammation may be associated with the pathophysiological mechanisms of mood disorders. Here, we investigated whether homeostatic model assessment of insulin resistance (HOMA-IR) and serum interleukin-1β (IL-1β) in acute ischemic stroke patients might be associated with post-stroke depression (PSD).
Materials and Methods: The prospective study was conducted in China from February 2019 to September 2020. HOMA-IR and clinical data were collected at the time of admission. Serum levels of IL-1β were determined with enzyme-linked immunosorbent assays. Symptoms of depression and anxiety were screened by using the Hamilton Depression and Anxiety Scale at 6 months after stroke, and PSD was diagnosed on the basis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The association of potential risk factors with PSD was analyzed with multivariate logistic regression analysis. Finally, the ability of HOMA-IR and IL-1β to predict PSD was assessed with receiver operating characteristic curve.
Results: A total of 305 people was included in the study; 65% were male, and the median age was 69.5± 11.8 years. At the 6-month follow-up, 113 patients (37.5%) showed depressive symptoms. In multivariate logistic regression analysis, HOMA-IR and IL-1β as graded variables were associated with an increased risk of PSD (P < 0.05). Receiver operating characteristic curve analysis indicated the highest sensitivity and specificity when the HOMA-IR and IL-1β were 1.96 and 38.71 pg/mL, respectively (P < 0.001). IL-1β improved the ability of HOMA-IR to diagnose PSD combined model area under the curve (AUC): 0.78; 95% CI: 0.72– 0.83; P < 0.001).
Conclusion: This study suggests that HOMA-IR and IL-1β are strongly associated with PSD at 6 months after stroke in patients with acute ischemic stroke. These two factors together improve the ability for early PSD assessment.
Keywords: insulin resistance, interleukin-1β, acute ischemic stroke, post-stroke depression, inflammation
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]