Influence Of Hyperglycemia On The Expression Of Basic Fibroblast Growth Factor After Acute Cerebral Infarction

Objective: Cerebral infarction is a pervasive disease and its incidence is rising in recent years. It is well known that cerebral infarction is associated with multiple risk factors, such as glucose, blood lipids, etal. The study of diabetes-induced acute cerebral infarction (Diabetes-Acute cerebral infarction, DACI) indicates that its incidence accounts for first in cerebral infarction. Hyperglycemia not only can lead to vascular endothelial cell damage by various mechanisms, but also can directly lead to the damage of the peripheral blood circulatory system, resulting in large vessels and small vascular lesions. But in impaired glucose regulation phase, the incidence of major vascular disease has increased significantly. Basic fibroblast growth factor (basic fibroblast growth factor, bFGF) is a kind of neurotrophic factors, with various biological activity, leading to growth, proliferation, differentiation and functional expression for various cells, inducing angiogenesis and reducing infarct volume in cerebral ischemic, playing an important role in maintaining normal function of the central nervous system. Therefore, the study of hyperglycemia especially impaired glucose regulation and the expression of bFGF in acute cerebral infarction is beneficial to the prevention and treatment of cerebral ischemic with hyperglycemia.Methods: Choose 90 cases of acute cerebral infarction in the Department of Neurology of the Second Hospital of He Bei Medical University, from December 2008 to June 2009. According to admission blood glucose, oral glucose tolerance test (oral glucose tolerance test, OGTT) and diabetes history, etal, we divide them into three groups: Diabetes-Acute cerebral infarction group (Diabetes-Acute cerebral infarction, DACI group), 30caces; Impaired glucose regulation -Acute cerebral infarction group (Impaired glucose regulation-Acute cerebral infarction, IGACI group), 30caces; Normal blood glucose-Acute cerebral infarction group (Normal blood glucose-Acute cerebral infarction, NGACI group), 30caces. Detect the peripheral blood levels of bFGF of each acute cerebral infarction group and the normal control group (Normal-Control, NC group), including 30 cases, by enzyme-linked immunosorbent assay (Enzyme-linked immunosorbent assay, ELISSA), in order to compare the differences expression of serum bFGF in DACI group, IGACI group, NGACI group and NC group. Detect the peripheral blood levels of fasting plasma glucose and blood lipids of each acute cerebral infarction group and the normal control group by biochemics method, in order to compare the differences blood levels of fasting plasma glucose and blood lipids in DACI group, IGACI group, NGACI group and NC group.Results: 1 In DACI group, IGACI group, NGACI group and NC group, age and gender are no significantly different (P> 0.05); hypertension is the most pervasive of the following disease, DACI group, IGACI group , NGACI group and NC group are significantly different (P <0.05).2 The serum concentration of bFGF is non-normal distribution (skewness coefficient = 0.814 peak skewness = 0.330);in DACI group, IGACI group, NGACI group ,the mean scores of bFGF levels in serum are (12.037, 12.191, 18.543),which are higher than the mean score of bFGF levels in serum in the NC group (5.544), the difference is statistically significant (P <0.05); in DACI group and IGACI group, the mean scores of bFGF levels in serum are different, but the difference is no statistically significant (P> 0.05); the mean scores of bFGF levels in DACI group and IGACI group are lower than the mean score of bFGF level in NGACI group, the difference is statistically significant (P <0.05).3 In IGACI group, 30 cases are both combining impaired fasting plasma glucose (impaired fasting plasma glucose, IFG)and impaired glucose tolerance(impaired glucose tolerance, IGT).4 The mean score of fasting plasma glucose level in serum in DACI group (8.659) is higher than the mean score of fasting plasma glucose level in serum in IGACI group (6.069), the difference is statistically significant (P <0.05); the mean scores of fasting plasma glucose levels in serum between NGACI group (4.741) and the NC group (4.970) are different, but the difference is no statistically significant (P> 0.05); the mean scores of fasting plasma glucose levels in DACI group and IGACI group are higher than the mean scores of fasting plasma glucose levels in NGACI group and NC group, the difference is statistically significant (P <0.05).5 The mean scores of CHOL, TG levels in DACI group, IGACI group and NGACI group (5.856, 3.042; 5.308, 3.085; 5.351, 3.111) are higher than the mean scores of CHOL, TG levels in NC group (3.853, 1.128 ), the difference is statistically significant (P <0.05); the mean scores of CHOL, TG levels in DACI group, IGACI group, and NGACI group are different, but the difference is no statistically significant (P> 0.05).6 In DACI group, IGACI group, NGACI group and NC group, the bFGF levels in serum are not associated with age and there is not a statistically significant correlation (P> 0.05).Conclusion: 1 According to the clinical data of the research, the patients in DACI group and IGACI group are more associated with hypertension, indicating that hyperglycemia is a risk factor for hypertension, which can lead to or aggravate acute cerebral infarction. Therefore, actively controlling the blood glucose and blood pressure levels can reduce the incidence of acute cerebral infarction, which has an important significance.2 The bFGF levels in serum in DACI group, IGACI group and NGACI group are significantly higher than the NC group, which indicates that cerebral ischemia can induce the expression of bFGF and suggests that bFGF can protective brain from ischemic injury, and which is accordant to animal experimental results; the bFGF levels in serum between DACI Group and IGACI group is no statistically significant difference, indicating that the expression levels of bFGF is no statistically significant correlation with blood glucose levels; the bFGF levels In serum in DACI group and IGACI group are significantly lower than NGACI group, indicating that hyperglycemia may aggravate acute cerebral infarction, resulting in the inadequate expression of bFGF, which may further aggravate brain injure.3 In IGACI group, 30 cases are both combining impaired fasting plasma glucose (IFG) and impaired glucose tolerance(IGT). It indicates that both impaired fasting plasma glucose and impaired glucose tolerance at the stage of impaired glucose regulation can aggravate cerebral ischemia.4 The blood glucose in DACI group is significantly higher than IGACI group, but the bFGF levels in serum between DACI group and IGACI group are no statistically significant difference, indicating that even at the stage of impaired glucose regulation the brain has been yielded significant injured and its harmful effects are similar to diabetes. Therefore, we should pay more attention to the impaired glucose regulation stage and enhance blood glucose control, in order to prevent or cure cerebral ischemia.5 The blood lipid levels in DACI group, IGACI group and NGACI group are significantly higher than the NC group, indicating that blood lipid can aggravate cerebral ischemia. The blood lipid levels in DACI group and IGACI group are elevated, indicating that hyperglycemia can lead to lipid metabolism, which can aggravate brain injure.6 In DACI group, IGACI group, NGACI group and NC group, the bFGF levels in serum are not associated with age.