| Objective: This study was designed to evaluate the correlation between inflammatory cytokines(IL-1β、IL-6、and IL-10)and major post-stroke depression(PSD),as well as their value as early diagnostic markers of major PSD.Research methods:(1)this project was approved by the ethics committee of Tongji hospital and was conducted from May 2019 to October 2019 after the patient signed the informed consent.The patients were then followed up for 3 months.(2)a total of 213 patients were enrolled from department of neurology,Tongji hospital,affiliated to Tongji medical college,Huazhong university of science and technology.They were hospitalized for the first-ever acute ischemic stroke(AIS),and 187 of them completed the evaluation in the 3-month follow up after stroke.Clinical data were recorded on admission,5ml peripheral venous blood was collected within 14 days after onset,the upper serum was stored at-80℃ after centrifugation.(3)serum concentrations of inflammatory cytokines IL-1β、IL-6、and IL-10 were determined by ELISA.(4)The diagnosis of major depression followed the Diagnostic and Statistical Manual of Mental Disorders,5th Edition(DSM-V)criteria for major depression.The Chinese version of 21-item Hamilton depression rating scale(HAM-D-21)was used to measure the severity of depressive symptoms.In the current analysis,major depression with 21-item HAM-D score≥17 at 3 months after onset of stroke was regarded as the main classification and divided the patients into major PSD and non-major PSD group.Serum inflammatory cytokines were compared between major PSD and non-major PSD patients.(5)inflammatory cytokines were natural log-transformed as log IL-1β、log IL-6、and log IL-10.SPSS,R and Med Calc software were used for all statistical analysis,and logistic regression analysis was used to evaluate the effect of clinical factors,serum indicators and inflammatory cytokines on major PSD.ROC analysis was performed to identify the cut-off points of the predictors.Results: 29 patients(15.5%)developed major PSD at 3 months after stroke.Serum log IL-1β levels(P = 0.11)and log IL-6 levels(P = 0.97)in the major PSD group and the non-major PSD group at admission were not significantly different(P > 0.05),in other words,there was no significant difference in serum IL-1β levels and IL-6 levels between the two groups.Log IL-10 levels were statistically different between the two groups(P < 0.05).Log IL-10 levels at admission were negatively correlated with HAM-D score at 3 months after stroke(r =-0.18,P = 0.014).In multivariable regression analysis,log IL-10 remained an independent predictor of major PSD after adjusting for confounding factors in the records,with an adjusted OR of 0.414(95%CI,0.183-0.938;P = 0.035).According to the ROC curve,the optimal cut-off value for predicting log IL-10 levels as a predictor of major PSD was 0.18 log pg/ml,the sensitivity was 44.8%,the specificity was 82.3%,and the area under the curve(AUC)was 0.664(95%CI,0.591-0.705;P = 0.002).After adjusting for confounders,there was an increased risk of major PSD associated with serum log IL-10 levels ≤ 0.18 log pg/ml(adjusted OR,0.346;95%CI,0.163-0.733).Conclusions: Reduced serum IL-10 levels at admission are associated with major PSD at 3 months,and serum log IL-10 levels ≤ 0.18 log pg/ml suggest that further intervention is needed to prevent the occurrence of major PSD.There is no significant correlation between serum IL-1β levels and IL-6 levels at admission and major PSD at 3 months. |
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