Higher fasting C-peptide is associated with post-stroke depression: a multicenter prospective cohort study

Abstract

Background Fasting C-peptide (FCP) has been shown to play an important role in the pathophysiology of mood disorders including depression and schizophrenia, but it is unknown whether it also predicts post-stroke depression (PSD). This study examined the association between FCP and PSD at 6 months after acute ischemic-stroke onset among Chinese subjects. Methods A total of 656 stroke patients were consecutively recruited from three hospitals of Wuhan city, Hubei province. Clinical and laboratory data were collected on admission. PSD status was evaluated by DSM-V criteria and 17-item Hamilton Rating Scale for Depression (HAMD-17) at 6 months after acute ischemic stroke. The χ2-test, Mann-Whitney U-test, and t-test were used to check for statistical significance. Multivariate logistic regression model was used to explore independent predictor of PSD. Results In the univariate analysis, significant differences were found between the PSD and non-PSD groups in terms of FCP level (p = 0.009). After multivariate adjustments, FCP remained a significant independent predictor of PSD, with an adjusted odds ratio of 1.179 (95%CI: 1.040–1.337, p = 0.010). Conclusions Higher FCP levels on admission were found to be associated with PSD at 6 months after acute ischemic-stroke onset. For stroke patients, doctors should pay attention to the baseline FCP for screening high-risk PSD in clinical practice.

Higher Concentration of Adrenocorticotropic Hormone Predicts Post-Stroke Depression

“…A total of 39.7% of acute ischemic stroke patients were diagnosed as PSD at 3 months in this study, which is similar to the incidence reported in previous studies. 31 , 32 Our results suggested that female and those who are physically inactive are at higher risk for PSD, which were consistent with previous studies. 33 , 34 Our results also demonstrated that patients with PSD had significantly increased stroke severity and worse functional outcome, which was the same as other studies.…”

“…The underlying mechanism might be that high levels of fasting C-peptide reflect insulin resistance and disrupted glucose metabolism, which contributes to depression. 31 Furthermore, previous studies have confirmed that neutrophil count 25 as well as IL.6 37 were involved in the development of PSD and our study came to the same conclusion.…”

Insulin administered intranasally, but not proinsulin C-peptide, normalises hormonal parameters and hypothalamic gene expression in male rats with type 2 diabetes and obesity

“…Имеются все основания полагать, что повышение уровня С-пептида в крови ассоциировано с повышением содержания С-пептида в мозге, тем более что рецепторный механизм в транспорте С-пептида через ГЭБ, который мог бы меняться в условиях гипер-С-пептидемии, не показан. Имеются данные о том, что повышенные уровни С-пептида при СД2 и ожирении могут негативно влиять на функционирование микрососудов головного мозга и быть причиной ряда функциональных расстройств нервной и сердечно-сосудистой систем (Alves et al 2019;Chen et al 2021;Wang et al 2021). В основе этого лежит доказанное тромболитическое действие С-пептида при его высоких концентрациях, а также стимулирующее влияние С-пептида на рост гладкомышечных клеток сосудов, приводящее к атеросклеротическим изменениям (Alves et al 2019).…”

Nomogram including indirect bilirubin for the prediction of post-stroke depression at 3 months after mild acute ischemic stroke onset

“…All tests were two-sided, and a P -value of 0.05 was defined to indicate statistical significance. Subsequently, variables with p < 0.05 were entered into a multivariable logistic regression model in a backward stepwise method ( 21 ). The above-mentioned analysis process was realized by Statistical Program for Social Sciences (SPSS) statistical software (version 25, Chicago, IL, USA).…”