Correlation Between Sleep Disorders And Plasma Markers After Ischemic Stroke

Objective: To investigate the changes in plasma Apelin-13,BDNF,IL-1?,and TNF-? concentrations in patients with ischemic stroke and the correlation between post-stroke sleep disorders(PSSD)and plasma markers;Methods: A total of 100 patients with acute ischemic stroke who were confirmed by cranial imaging and agreed to participate in the study were recruited from January 2018 to December 2018.They were admitted to the Department of Neurology,South China Affiliated Neurology.63 patients,aged 33-82 years,with an average age of 61.78 ± 8.05 years;76 patients with hypertension,33 cases of diabetes,10 cases of dyslipidemia,40 cases of smoking,16 cases of previous stroke history,and no sleep disorders before onset.All patients completed the Pittsburgh sleep quality index(PSQI)score within 7 days after admission,and collected general clinical data from patients,including demographic information and clinical data,which enbodies routine biochemistry,homocysteine,blood lipids,head imaging data and past history(diabetes,coronary heart disease,hypertension,etc.);and early morning fasting venous blood was drawn from the patient within 7 days after onset,and the enzyme-linked immunosorbent assay was used.Assay,ELISA)was used to test the plasma concentrations of Apelin-13,BDNF,IL-1? and TNF-?;and follow-up was completed within about 6 months after discharge.SPSS software was used for statistical analysis of the collected data.P <0.05 indicated that the difference was statistically significant.Results: 1.Compared with the normal control group,the plasma Apelin-13 concentration in patients with ischemic stroke was significantly reduced(p <0.001).2.In patients with ischemic stroke,compared with patients without sleep disturbance,plasma Apelin-13 concentration in patients with sleep disorder decreased significantly(P <0.001).In addition,the plasma IL-1? and TNF-? concentrations increased significantly,and the plasma BDNF concentrations decreased significantly in patients with sleep disorders(P <0.05).3.The amount of plasma Apelin-13 changes was significantly negatively correlated with the amount of PSQI score changes(P <0.001),and was significantly negatively correlated with the amount of TNF-? changes(P <0.001),but not significantly changed with the amount of IL-1? and BDNF.Correlation(P> 0.05).4.Without adjusting any factors,plasma Apelin-13 concentration was independently related to the occurrence of sleep disturbance after ischemic stroke,and its hazard ratio was 0.693(0.524,0.905),P <0.001.After adjusting for various confounding factors such as age,gender,smoking history,comorbidities,nutritional status,and inflammation indicators,plasma Apelin-13 concentration was still independently associated with the occurrence of sleep disorders after ischemic stroke,with a hazard ratio of 0.803(0.683,0.963),P = 0.008.5.In the univariate analysis,indicators with significant correlation with Apelin-13 were included in the multiple linear regression model,and gender was adjusted at the same time.The results showed that TNF-?,MRS score,and HDL-C were Independent factors related to plasma Apelin-13 in patients with ischemic stroke.Conclusions 1.Plasma Apelin-13 and BDNF levels decrease and plasma IL-1? and TNF-? levels increase in patients with sleep disturbance after ischemic stroke.2.Plasma Apelin-13 is an independent predictor of sleep disturbance after stroke and may be involved in the inflammatory pathological mechanism of sleep disturbance in ischemic stroke patients.