BACKGROUND: Inflammation may play an important role in atherothrombosis and in promoting cerebral damage after stroke. We hypothesized that plasma adipocytokine concentrations would be associated with risk of stroke in older people. METHODS: Nested case-control study from the Prospective Study of Pravastatin in the Elderly (PROSPER). Subjects were aged 70-82 years and followed up for a mean of 3.2 years: 266 incident stroke cases (179 confirmed as ischaemic) were compared with 532 controls matched for age, gender and treatment allocation (pravastatin or placebo). Adipocytokines [adiponectin, interleukin- (IL-)18 and tumour necrosis factor (TNF)alpha] were measured on stored baseline plasma samples. RESULTS: Elevated plasma adiponectin was associated with lower risk of ischaemic stroke on univariate analysis: odds ratio (OR) 0.78 per 1 SD increase (95% CI 0.62-0.97). There were no associations of IL-18 or TNFalpha with risk for ischaemic or total strokes. In multivariate models the independent predictors of ischaemic stroke were prior cerebrovascular accident (OR 2.68, 95% CI 1.60-4.50), any alcohol use (1.98, 1.33-2.94), triglycerides (1.40, 1.11-1.77), Barthel score (0.75, 0.58-0.96) and known diabetes (1.72, 1.04-2.83); adiponectin, IL-18 and TNFalpha did not contribute. A similar pattern of risk was seen for total stroke. CONCLUSIONS: Reduced adiponectin may have a modest role in the aetiology of ischaemic stroke in older people, however IL-18 and TNFalpha are unlikely to play any important part. These adipocytokines do not have clinical predictive utility; history of prior cerebrovascular accident, known diabetes mellitus, prior disability and higher alcohol intake explain much of the stroke risk.
BACKGROUND: Inflammation may play an important role in atherothrombosis and in promoting cerebral damage after stroke. We hypothesized that plasma adipocytokine concentrations would be associated with risk of stroke in older people. METHODS: Nested case-control study from the Prospective Study of Pravastatin in the Elderly (PROSPER). Subjects were aged 70-82 years and followed up for a mean of 3.2 years: 266 incident stroke cases (179 confirmed as ischaemic) were compared with 532 controls matched for age, gender and treatment allocation (pravastatin or placebo). Adipocytokines [adiponectin, interleukin- (IL-)18 and tumour necrosis factor (TNF)alpha] were measured on stored baseline plasma samples. RESULTS: Elevated plasma adiponectin was associated with lower risk of ischaemic stroke on univariate analysis: odds ratio (OR) 0.78 per 1 SD increase (95% CI 0.62-0.97). There were no associations of IL-18 or TNFalpha with risk for ischaemic or total strokes. In multivariate models the independent predictors of ischaemic stroke were prior cerebrovascular accident (OR 2.68, 95% CI 1.60-4.50), any alcohol use (1.98, 1.33-2.94), triglycerides (1.40, 1.11-1.77), Barthel score (0.75, 0.58-0.96) and known diabetes (1.72, 1.04-2.83); adiponectin, IL-18 and TNFalpha did not contribute. A similar pattern of risk was seen for total stroke. CONCLUSIONS: Reduced adiponectin may have a modest role in the aetiology of ischaemic stroke in older people, however IL-18 and TNFalpha are unlikely to play any important part. These adipocytokines do not have clinical predictive utility; history of prior cerebrovascular accident, known diabetes mellitus, prior disability and higher alcohol intake explain much of the stroke risk.
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Authors: Swapnil N Rajpathak; Robert C Kaplan; Sylvia Wassertheil-Smoller; Mary Cushman; Thomas E Rohan; Aileen P McGinn; Tao Wang; Howard D Strickler; Philipp E Scherer; Rachel Mackey; David Curb; Gloria Y F Ho Journal: Stroke Date: 2011-05-05 Impact factor: 7.914
Authors: Andreas Papadopoulos; Konstantinos Palaiopanos; Harry Björkbacka; Annette Peters; James A de Lemos; Sudha Seshadri; Martin Dichgans; Marios K Georgakis Journal: Neurology Date: 2021-12-30 Impact factor: 9.910
Authors: Hamidreza Saber; Jayandra J Himali; Ashkan Shoamanesh; Alexa Beiser; Aleksandra Pikula; Tamara B Harris; Ronenn Roubenoff; Jose Rafael Romero; Carlos S Kase; Ramachandran S Vasan; Sudha Seshadri Journal: Stroke Date: 2015-09-03 Impact factor: 7.914
Authors: Barbara J Jefferis; Peter H Whincup; Paul Welsh; S Goya Wannamethee; Ann Rumley; Lucy T Lennon; Andrew G Thomson; Claire Carson; Shah Ebrahim; Gordon D O Lowe Journal: Atherosclerosis Date: 2008-12-06 Impact factor: 5.162