Higher Serum Lactic Dehydrogenase is Associated with Post-Stroke Depression at Discharge

Abstract

Purpose

Post-stroke depression (PSD) is one of the most common and severe psychological sequelae after stroke, negatively affecting the patient’s functional outcome and quality of life. Rapidly measurable biomarkers to predict PSD are pivotal for the optimized care and allocation of healthcare resources. Lactic dehydrogenase (LDH) levels are increased in patients with central nervous system (CNS) disorders such as cerebral infarction and hypoxic–ischemic encephalopathy, which may be related to the occurrence of PSD in acute ischemic stroke (AIS) patients. This study aimed to investigate whether LDH levels on admission are associated with PSD at discharge.

Patients and Methods

A multicenter prospective cohort study was conducted, including all consecutive AIS patients within 7 days after symptom onset from May 2018 to October 2019. According to the distribution of LDH and the number of patients, patients were divided into equal tertiles. PSD was evaluated by DSM-V criteria and the 17-item Hamilton Rating Scale for Depression (HRSD-17) at discharge.

Results

A total of 518 AIS patients were included. The optimal cut-off points of LDH were: lowest tertile (T1) 102–159/L, middle tertile (T2) 160–189 U/L, and upper tertile (T3) 190–520 U/L. A total of 249 patients (48.07%) were diagnosed with PSD at discharge. After adjusting for potential confounding factors, the odds ratio of T3 PSD was 1.698 (95% CI, 1.070–2.694, P=0.025), compared with T1.

Conclusion

In summary, LDH serum levels on admission are associated with PSD at discharge. Clinicians should pay more attention to the baseline LDH level in screening for PSD at discharge.

Keywords:

• post-stroke depression
• lactic dehydrogenase
• screen
• cohort study

Data Sharing Statement

The data and R codes that was used to generate the results can be made available upon request from the corresponding author.

Ethics Approval and Informed Consent

The protocol was approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (ID: TJ-IRB20171108). Written informed consent was obtained from all subjects or their caregivers.

Author Contributions

All authors met the following conditions:

1. Made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas.

2. Drafted or wrote, or substantially revised or critically reviewed, the article.

3. Agreed on the journal to which the article will be submitted.

4. Reviewed and agreed on all versions of the article before submission, during revision, the final version accepted for publication, and any significant changes introduced at the proofing stage.

5. Agreed to take responsibility and be accountable for the contents of the article.

Disclosure

All authors declare no competing interests.