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High serum levels of leptin are associated with post-stroke depression

Published online by Cambridge University Press:  09 April 2009

I. Jiménez ,
T. Sobrino ,
M. Rodríguez-Yáñez ,
M. Pouso ,
I. Cristobo ,
M. Sabucedo ,
M. Blanco ,
M. Castellanos ,
R. Leira  and
J. Castillo
I. Jiménez
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
T. Sobrino
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
M. Rodríguez-Yáñez
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
M. Pouso
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
I. Cristobo
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
M. Sabucedo
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
M. Blanco
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
M. Castellanos
Affiliation:
Department of Neurology, Hospital Universitari Doctor Josep Trueta, Girona, Spain
R. Leira
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
J. Castillo*
Affiliation:
Department of Neurology, Neuropsychology Laboratory, Clinical Neuroscience Research Laboratory, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
*
*Address for correspondence: Professor J. Castillo, M.D., Ph.D., Servicio de Neurología, Hospital Clínico Universitario, 15706Santiago de Compostela, Spain. (Email: jose.castillo@usc.es)
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Abstract

Background

Depression is a frequent mood disorder that affects around 33% of stroke patients and has been associated with both poorer outcome and increased mortality. Our aim was to test the possible association between inflammatory and neurotrophic molecular markers and the development of post-stroke depression.

Method

We studied 134 patients with a first episode of ischemic stroke without previous history of depression or speech disorders. We screened for the existence of major depression symptoms in accordance with DSM-IV criteria and a Yesavage Geriatric Depression Scale (GDS) score >11 at discharge and 1 month after stroke. At these times, serum levels of molecular markers of inflammation [interleukin (IL)−1β, IL-6, intracellular adhesion molecule 1 (ICAM-1), tumor necrosis factor (TNF)-α, leptin and high-sensitivity C-reactive protein (hs-CRP)] and neurotrophic factors [brain-derived neurotrophic factor (BDNF)] were measured by enzyme-linked immunosorbent assay (ELISA).

Results

Twenty-five patients (18.7%) were diagnosed as having major depression at discharge. Out of 104 patients who completed the follow-up period, 23 were depressed at 1 month (22.1%). Patients with major depression showed higher serum leptin levels at discharge [43.4 (23.4–60.2) v. 6.4 (3.7–16.8) ng/ml, p<0.001] and at 1 month after stroke [46.2 (34.0–117.7) v. 6.4 (3.4–12.2) ng/ml, p<0.001). Serum levels of leptin >20.7 ng/ml were independently associated with post-stroke depression [odds ratio (OR) 16.4, 95% confidence interval (CI) 5.2–51.5, p<0.0001]. Leptin levels were even higher in the eight patients who developed depression after discharge [114.6 (87.6–120.2) v. 7.2 (3.6–13.6) ng/ml, p<0.0001].

Conclusions

Serum leptin levels at discharge are found to be associated with post-stroke depression and may predict its development during the next month.

Keywords

Depressionischemic strokeleptin
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 7 , July 2009 , pp. 1201 - 1209
Copyright
Copyright © Cambridge University Press 2009

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