Serum leptin is associated with first-ever ischemic stroke, lesion size and stroke severity in a Chinese cohort

ABSTRACT

Objective: Leptin may be associated with cardiovascular disease. We tested to determine whether leptin is a marker for first-ever acute ischemic stroke (AIS) in a nested case-referent study.

Methods: Consecutive patients with first-ever AIS from May 2017 to December 2017 were included. Referents were matched for sex, age and body mass index. Serum leptin levels and routine tests were examined in both groups.

Results: The median serum level of leptin in the stroke patients was 14.3 (interquartile range [IQR], 7.2–21.7) ng/ml, which was significantly higher (P < 0.001) than in the referents (10.7; 5.7–13.6 ng/ml). There was a positive correlation between serum level of leptin and National Institute of Health Stroke Scale score (r[Spearman] = 0.43, P < 0.001). In addition, serum leptin levels paralleled lesion size. Median serum level of leptin in patients with small lesions, medium lesions and large lesions was 7.3 (IQR, 5.3–14.3) ng/ml, 13.9 (IQR, 7.0–21.3) ng/ml, 20.5 (IQR, 12.4–32.7) ng/ml, respectively (analysis of variance: P < 0.001). In the univariate model matching for sex and age, leptin as a continuous variable was associated with AIS, after adjustment for possible confounders (odds ratio [OR] 1.07, 95% confidence interval [CI]: 1.04–1.11; P < 0.001). After adjusting for all other factors, leptin remained an independent stroke predictor with an adjusted OR of 1.03 (95% CI, 1.00–1.10; P = 0.006). Interestingly, the association between AIS and leptin level was more pronounced among men (adjusted OR = 1.05, 95% CI: 1.01–1.12; P < 0.001) when compared with women (adjusted OR = 1.03, 95% CI: 1.10–1.11; P = 0.009).

Conclusion: Serum leptin is associated with first-ever AIS, lesion size and stroke severity in a Chinese cohort.

KEYWORDS:

• Acute ischemic stroke
• leptin
• Chinese
• serum
• biomarker

Acknowledgments

We also express our gratitude to all the patients who participated in this study and thereby made this work possible. All authors have contributed significantly, and that all authors agree with the content of the manuscript. The content has not been published or submitted for publication elsewhere.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics, consent and permissions

The present study has been approved by the Ethics Committee of the First Affiliated Hospital of Kunming Medical University. All participants or their relatives were informed of the study protocol and their written informed consents were obtained.

Additional information

Funding

This study was supported by grant from National Natural Science Foundation of China: [Grant Number 81671175].

Notes on contributors

Guoyi Liu

Guoyi Liu is a Neurologist and holds a Master's degree in Neurology (Kunming Medical University). She has several publications in the application of Neurology in the cerebrovascular disease and multiple sclerosis. She has also presented numerous posters at Chinese Neurology conferences regarding stroke, multiple sclerosis. She provides continuing education lectures regarding neurology at Yunnan province conference.

Minna Dong

Minna Dong is an Emergency Physician and holds a Master's degree in Neurology (Kunming Medical University). She has several publications in the application of emergency medicine and cerebrovascular disease. She provides continuing education lectures regarding emergency medicine at Yunnan province conference.

Shu Ma

Shu Ma is a Neurologist and holds a Master's degree in Neurology (Kunming Medical University). She has several publications in the application of Neurology in the hyperbaric and multiple sclerosis. She provides continuing education lectures regarding neurology at Yunnan province conference.

Liyan Fu

Liyan Fu is a Neurologist and holds a Master's degree in Neurology (Kunming Medical University). She has several publications in the application of Neurology in the hyperbaric and cerebrovascular disease. She provides continuing education lectures regarding neurology at Yunnan province conference.

Yun Xiao

Yun Xiao is an ICU physician and holds a Master's degree in Neurology (Kunming Medical University). He has several publications in the field of ICU. He provides continuing education lectures regarding ICU at Yunnan province conference.

Lianmei Zhong

Lianmei Zhong is a Neurologist and holds a Ph.D. diploma in Life Sciences (Yunnan University). She has several publications in the field of Neurology and Life Sciences. She has also presented numerous posters at national and Chinese Neurology conferences. She also provides continuing education lectures regarding Neurology Practitioners at their Yunnan province conference.

Jia Geng

Jia Geng is a Neurologist and holds a Ph.D. diploma in Neurology (Sun Yat-sen University). He has several publications in the application of Neurology in the cerebrovascular disease and multiple sclerosis. He has also presented numerous posters at national and international Neurology conferences regarding stroke, multiple sclerosis and stem cells. He also provides continuing education lectures regarding stroke to Neurology Practitioners at their Yunnan province conference.