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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

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