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Liu P, Hao J, Zhang Y, Wang L, Liu C, Wang J, Feng J, Zhang Y, Hou H, Zhang L. Acute Ischemic Stroke Comorbid with Type 2 Diabetes: Long-Term Prognosis Determinants in a 36-Month Prospective Study for Personalized Medicine. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2022; 26:451-460. [PMID: 35917518 DOI: 10.1089/omi.2022.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Ischemic stroke (IS) is often comorbid with type 2 diabetes mellitus (T2DM) wherein the determinants of long-term outcomes, beyond the acute stroke phase, are not adequately known. This study identified the determinants of long-term outcomes for diabetic IS patients through a prospective nested case-control study in 624 patients treated with conservative measures (38.60% females, mean age: 63.85 years). After 36-month follow-up, 117 (18.8%) patients with poor outcome were enrolled in the case group. The poor outcome was defined with a modified Rankin Scale (mRS) score ≥3. Meanwhile, 374 (59.9%) patients with good outcome, defined as (mRS score <3), were included in the control group. Patients who died (n = 32) or lost to follow-up (n = 101) were excluded in analysis. Poor prognostic outcome was positively associated with (1) the pulse rate at admission, (2) diastolic blood pressure (DBP), and (3) fasting blood glucose (FBG) during follow-up, whereas physical activity and lipid-lowering treatment during follow-up were negatively associated. Importantly, a forecasting model with these indicators distinguished the patients with good versus poor outcomes with 70.1% sensitivity and 73.5% specificity. Health care professionals and laboratory medicine scholars may want to monitor an increase in DBP and FBG during follow-up, as well as physical activity and lipid-lowering treatment, in relationship to the prognosis of IS with comorbid T2DM after conservative therapies. The proposed predictive model for personalized/precision medicine requires field testing in independent studies, and might help risk stratification with theranostic tests for patients with acute IS who also have a diagnosis of T2DM.
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Affiliation(s)
- Pengcheng Liu
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Jiheng Hao
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China
| | - Yichun Zhang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Lu Wang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Chao Liu
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China
| | - Jiyue Wang
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China
| | - Jingjun Feng
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China
| | - Yanbo Zhang
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Haifeng Hou
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Liyong Zhang
- Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng, China
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Zhao PC, Xu SN, Huang ZS, Jiang GW, Deng PC, Zhang YM. Hyperbaric oxygen via mediating SIRT1-induced deacetylation of HMGB1 improved cReperfusion inj/reperfusion injury. Eur J Neurosci 2021; 54:7318-7331. [PMID: 34523745 DOI: 10.1111/ejn.15458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 12/23/2022]
Abstract
Ischemic stroke leads to severe neurological dysfunction in adults. Hyperbaric oxygen (HBO) induces tolerance to cReperfusion inj/reperfusion (I/R) injury. Therefore, our aims were to investigate whether SIRT1 participates in regulatingin the neuro-protective effect of HBO in a cerebral I/R model and its mechanism. Mice N2a cells were used to construct an oxygen deprivation/reperfusion (OGD/R) model to simulate in vitro brain I/R injury and to evaluate the role of HBO in OGD/R stimulated cells. Cell proliferation was detected using MTT, and apoptosis was determined by flow cytometry. ELISA was used to measure the concentration of TNF-α, IL-1β and IL-6 related inflammatory factors. RT-qPCR and western blot assays were performed to test the expression of SIRT1. Immunoprecipitation was used to detect acetylation of HMGB1. Expression of SIRT1 was obviously reduced after OGD/R treatment in N2a cells, while SIRT1 was obviously enhanced in HBO treated cells. Moreover, knockdown of SIRT1 induced neuro-inflammation damage in cells and HBO effectively improved the inflammatory response in OGD/R treated cells by affecting SIRT1 levels. Furthermore, HBO induced the deacetylation of HMGB1 via regulating SIRT1. Interestingly, HBO via regulating the SIRT1-induced HMGB1 deacetylation and suppressing MMP-9 improved ischemic brain injury. HBO regulated ischemic brain injury via regulation of SIRT1-induced HMGB1 deacetylation, making it a potential treatment for ischemic brain injury treatment.
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Affiliation(s)
- Peng-Cheng Zhao
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China.,Clinical College, Anhui Medical University, Hefei, Anhui Province, China
| | - Shao-Nian Xu
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China
| | - Zhen-Shan Huang
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China
| | - Guo-Wei Jiang
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China
| | - Peng-Cheng Deng
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China
| | - Yong-Ming Zhang
- Department of Neurosurgery, Anhui No. 2 Provincial People's Hospital, Hefei, Anhui Province, China
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