Expression And Signifcans Of Plasma Ghrelin In Patients With Ischemic Cerebrovascular Disease

ObjectiveCerebrovascular disease has high incidence of morbidity, disability, mortality and recurrence, and it is seriously harmful to human health. Ischemic cerebrovascular disease is accounted for about 85%. Ischemic cerebrovascular disease has a variety of risk factors, and the pathophysiological changes in the infarct and surrounding penumbra are more complex. Currently there is no ideal treatment for ischemic stroke. How to make risk factors closely link its pathophysiological changes of ischemic cerebrovascular disease become a new trend for future research. Therefore, the search for a kind of endogenous mediator closely related to ischemic stroke risk factors and pathophysiological changes after brain ischemia is very important, not only for the treatment of ischemic stroke itself,but also for the prevention and reduced recrudescence Ghrelin is closely related to cerebral vascular disease and its risk factors. My study aims to investigate the level of plasma growth hormone in patients with ischemic cerebrovascular disease changes, and its correlation with traditional risk factors for cerebrovascular disease, in order to find new ways to prevent and treat with ischemic cerebrovascular disease, and pave a way for future clinical use with ghrelin.Methods72 cases with ischemic cerebrovascular disease were selected (including 40 cases with cerebral infarction,32 cases with transient ischemic attack) and 60 cases were selected as control.(1) All subjects were recorded including their age, sex, height, weight, tobacco, alcohol history, history of hypertension, diabetes mellitus and hyperlipidemia. Their blood pressure was measured, a comprehensive physical examination on nervous system was conducted, electrocardiogram and head CT and/or MRI were taken simultaneously. Patients were scored with cerebral infarction neurological deficit under U.S. National Institutes of Health.standards (N.IHSS score, see table).(2) Fasting (fasting for more than 10h) venous blood samples 5mL were collected,3ml of them was injected to a cold test tube immediately which containing EDTA-2Na (1 mg/ml) and aprotinin (0.6 TIU/ml), rapid centrifugation (1600r/min,4℃,15 min), Then plasma was collected, preserved at-80℃, for testing the concentration of ghrelin. And take 2mL blood samples for biochemical test as lipids, blood glucose.Results1) The comparison of fasting plasma growth hormone between groupsFasting plasma ghrelin levels in Ischemic cerebrovascular disease (ICVD) [65.5±28.8ng/L] was significantly lower than control group [85.5±21.9ng/ L] (P<0.01); Fasting patients ghrelin levels in cerebral infarction (CI) [60.8±24.31ng/L] was significantly lower than transient ischemic attack (TIA) group [72.8±26.7ng/L] (P<0.05); Fasting plasma ghrelin levels in CI group were lower than the control group (P<0.05); Fasting plasma ghrelin levels in TIA patients was not significantly different compared with control group (P>0.05).Fasting plasma ghrelin levels between men and women in CI group was significantly different (P<0.05), whereas fasting plasma ghrelin levels between men and women in TIA group. ICVD group and the control group were not significantly different (P>0.05). There are significant differences in fasting plasma ghrelin levels between small area of cerebral infarction group and the large area cerebral infarction (P<0.05). There aren't significant difference between small area cerebral infarction and moderate cerebral infarction group, in fasting ghrelin level (P> 0.05), and so the large area of cerebral infarction group and the moderate infarction group.There aren't significant difference between anterior and posterior circulation system group of TIA patients in levels of ghrelin (P> 0.05). Fasting ghrelin levels between groups with risk factors and those without risk factors were significantly different (P<0.05); wheareas the groups which not accompanied by risk factor were significantly different compared with hypertension group (P<0.05). The group which not accompanied by risk factor was not significantly different compared with pure fat hyperinsulinemia group, hyperglycemia group and heart disease group (P> 0.05). 2) Analysis between levels of fasting plasma ghrelin and related factorsFasting plasma ghrelin levels and systolic blood pressure (SBP) were negatively correlated (r=-0.5128,p<0.01); and body mass index (BMI) was negatively correlated (r=-0.83, p<0.01); but blood glucose was (BS) positively correlated (r= 0.6497, p<0.01). There aren't difference between levels of fasting plasma growth hormone and NIHSS score in patients with cerebral infarction (P>0.05).3) Multiple stepwise regression analysis(1) BS, TG, CRP, SBP, BMI may affect fasting levels of plasma ghrelin in patients with ischemic cerebrovascular disease, and BS has the greatest impact.(2) ID, BMI, SBP may affect fasting levels of plasma ghrelin in patients with cerebral infarction, and BMI has the greatest impact.Conclusion1) Ghrelin level decreased significantly in patients with Ischemic cerebrovascular disease may be related to inflammatory changes and reduction in the number of receptors secondary to cerebral ischemia, which aggravate ischemic damage.2) Fasting plasma ghrelin levels was negatively correlated with systolic blood pressure (SBP) (r=-0.5128, p<0.01); it was negatively correlated with body mass index (BMI) (r=-0.83, p<0.01); but it was positively correlated with blood glucose (BS) level (r=0.6497, p<0.01).3) BS, TG, SBP, BMI, CRP is closely related to fasting plasma ghrelin levels change in patients with Ischemic cerebrovascular disease, and BS has the greatest impact. ID, BMI, SBP are closely related to fasting plasma ghrelin levels in patients with cerebral infarction changes and BMI has the greatest impact.