Abstract:
OBJECTIVES:In conditions with reduced glucose levels/inability of glucose utilization, ketone bodies, especially beta-hydroxybutyrate (BHB), become a major energy source in the brain. In animal models, BHB infusion shows acute beneficial effects on the hypoxic brain. The present prospective observational study is the first to assess the relationship between on-admission capillary blood BHB levels and acute stroke severity/short-term functional outcomes. METHODS:A total of 51 consecutive first-ever stroke patients (46 ischemic stroke) admitted within 24 hours since the symptom onset and ≤ 44 hours since the last meal were evaluated for stroke severity (National institutes of health stroke scale, NIHSS) and for disability (modified Rankin scale, mRS) 3 months post-stroke. RESULTS:On-admission BHB values ranged between 0 and 1.6 mmol/l, with 43 (84.3%) values ≤ 0.4 mmol/l (normal). Higher BHB values were independently associated with longer fasting and hyperglycemia, whereas lower values were associated with dyslipidemia and diabetes. No association between on-admission BHB levels and NIHSS scores at presentation or day 5 was observed. The BHB levels considered either as continuous or as binary (> 0.4 vs ≤ 0.4 mmol/l) variables were independently (adjustment for age, NIHSS score at presentation, fasting period, stroke type, hyperglycemia, diabetes, and dyslipidemia) associated with lower odds of mRS 0-2 (non-to-mild disability) 3 months post-stroke: OR = 0.09 (95% CI 0.00-0.97, P = 0.047) and OR = 0.07 (95% CI 0.00-0.78, P = 0.028), respectively. DISCUSSION:This preliminary study suggests that higher on-admission BHB values are associated with poorer stroke outcomes and emphasizes the need for further investigations.
journal_name
Neurol Resjournal_title
Neurological researchauthors
Pikija S,Trkulja V,Simundic AM,Vrcek E,Boskovic K,Bacani Sdoi
10.1179/1743132813Y.0000000239subject
Has Abstractpub_date
2013-11-01 00:00:00pages
959-67issue
9eissn
0161-6412issn
1743-1328pii
ner3241journal_volume
35pub_type
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journal_title:Neurological research
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更新日期:2010-07-01 00:00:00
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更新日期:2001-01-01 00:00:00