The Controlling Nutritional Status score at admission could be a useful prognostic marker of 3-mo functional outcomes in patients with acute ischemic stroke.

The pathogenesis of cerebral small vessel disease, a disease that involves white matter lesions (WMLs) and cerebral microbleeds (CMBs), is thought to be associated with endothelial dysfunction. Flow-mediated dilation (FMD) has been used to measure endothelium-dependent vasodilation. The aim of this study was to investigate the association between endothelial function (as measured by FMD) and cerebral small vessel disease. Patients with a history of cerebrovascular disease and comorbidities were enrolled in this study (n=102; 69 males, 70.1±9.2 years). The patients were divided into two groups according to the severity of WMLs, which were assessed by Fazekas classification; grades 0 to 1 as mild WMLs group and grades 2 to 3 as severe WMLs group. A gradient-echo MRI was performed in 96 patients (94.1%) to evaluate whether CMBs were present. The patients in the severe WMLs group (n=40) were older (P=0.001), more frequently exhibited hypertension (P=0.045) and diabetes mellitus (P=0.026) and possessed lower FMD values (P<0.001) than the patients in the mild WMLs group (n=62). CMBs were observed in 30 patients (31.3%). Using receiver operating characteristic curves, the optimal FMD cutoff values for predicting the presence of severe WMLs and CMBs were 3.9% and 3.7%, respectively. On multivariate logistic analysis, FMD <4.0% (odds ratio 9.50; 95% confidence interval 3.55-28.83) was independently associated with severe WMLs. Additionally, FMD <3.8% (5.82; 2.23-16.50) was also associated with the presence of CMBs. Endothelial dysfunction as evaluated by FMD may be predictive of the severity of cerebral small vessel disease.

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Aims: Alpha-2-macroglobulin (α2MG) is thought to be associated with inflammatory reactions and procoagulant properties that might cause ischemic stroke. Endothelial dysfunction plays an important role in atherosclerosis development and in the occurrence of cardiovascular events. In this study, we investigated whether serum α2MG levels, endothelial function, and endothelial progenitor cell (EPC) number were associated in patients with chronic stroke or cardiovascular risk factors.Methods: Patients with a history of stroke or any established cardiovascular risk factors were enrolled in this study (n = 102; 69 men, 70.1 ± 9.2 years). Endothelial function was assessed by flow-mediated dilation (FMD). EPC numbers (CD34+/CD133+) were measured using flow cytometry (n = 91). Serum α2MG levels were measured by nephelometry.Results: Patients in the highest tertile of serum α2MG levels were older (P = 0.019) and more frequently exhibited dyslipidemia (P = 0.021). Univariate-regression analysis revealed that increased α2MG levels were negatively associated with FMD values (r = −0.25; P = 0.010), whereas increased EPC numbers were positively associated (r = 0.21; P = 0.044). Multivariate-regression analysis adjusted for male gender, hypertension, and severe white-matter lesions showed that serum α2MG levels were independently associated with FMD values (standardized partial regression coefficient [β] −0.185; P = 0.033), although not significantly associated with EPC numbers.Conclusion: Serum α2MG levels might reflect endothelial dysfunction evaluated by FMD in patients with chronic stroke or cardiovascular risk factors.