The association between serum adipocyte fatty acid–binding protein and 3-month disability outcome after aneurysmal subarachnoid hemorrhage

Abstract

Background: Adipocyte fatty acid-binding protein (FABP4) is an adipokine that plays an important role in development of cardiovascular and metabolic diseases. The aim of this study was to assess the 3-month prognostic value of serum levels of FABP4 in Chinese patients with aneurysmal subarachnoid hemorrhage (aSAH) on hospital admission. Methods: This was a prospective observational study from a stroke treatment center in Zhengzhou, China. From October 2016 to May 2018, patients with aSAH who were hospitalized within 24 h were included. In addition, 202 age-and gender-matched healthy volunteers were assigned to the healthy control group. At admission, serum levels of FABP4 were measured, and patients' characteristics, Hunt-Hess grade, and modified Fisher grade evaluated. At 3-month follow-up, functional outcome (Glasgow Outcome Scale score; dichotomized as poor [score 1-3] or good [score 4-5]) and all-cause mortality were recorded. Univariate and multivariate logistic regression models were used to investigate the association of FABP4 with the two endpoints. Results: A total of 418 patients with aSAH were included in this study. The median age was 58 years (interquartile range, 49-66 years), and 57.9% were women. FABP4 serum levels were related to Hunt-Hess score (r[Spearman] = 0.381; P < 0.001). Patients with a poor outcome and non-survivors had significantly increased serum FABP4 levels on admission (P < 0.001 for all). In multivariate logistic regression analysis, FABP4 was an independent predictor of poor outcome and mortality, with increased risks of 7% (odds ratios 1.07, 95% confidence interval [CI] 1.02-1.13; P = 0.001) and 5% (odds ratio 1.05, 95% CI, 1.01-1.12; P = 0.003), respectively. Receiver operating characteristics to predict functional outcome and mortality were significantly different between conventional risk factors (difference area under the curve 0.024, 95% CI 0.018-0.032) and FABP4 plus conventional risk factors (area under the curve 0.015, 95%CI 0.011-0.020). After FABP4 was added to the existing risk factors, mortality was better reclassified and was associated with the net reclassification improvement statistic (P = 0.009), while poor outcome was better reclassified and associated with both the integrated discrimination improvement and net reclassification improvement statistics (P < 0.05 for all). Conclusions: Elevated serum FABP4 levels were related to poor outcome and mortality in a cohort of patients with aSAH.

Prognostic capacity of the systemic inflammation response index for functional outcome in patients with aneurysmal subarachnoid hemorrhage

“…In recent years, the impacts of systemic inflammation in aSAH have captured the interest of researchers and various novel inflammatory markers such as have been used to predict the prognosis of aSAH (16)(17)(18). Nevertheless, tests of these biomarkers are not routinely used in clinical applications owing to the cost, technical expertise and equipment setup.…”

Interleukin-6 in Cerebrospinal Fluid Small Extracellular Vesicles as a Potential Biomarker for Prognosis of Aneurysmal Subarachnoid Haemorrhage

“…DCI was confirmed as a new focal neurological deficit, consciousness disorder, or a new infarct based on CT scans or MRI. 31 Surgical clip or endovascular coil was performed in all patients with aSAH. Functional outcome was assessed using the Modified Rankin Scale (mRS) using structured WeChat or telephone interviews by two trained nurses.…”

“…DCI was confirmed as a new focal neurological deficit, consciousness disorder, or a new infarct based on CT scans or MRI. 31 …”

The association between hemoglobin concentration and clinical outcomes after aneurysmal subarachnoid hemorrhage: Insights from the LongTEAM registry

“…The median duration from admission to the onset of DVT exhibited no significant disparities among patients within the anemic, standard, and elevated HGB groups (7.0 [5.5-15.0] vs. 5.5 [3.3-9.0] vs. 10.5 [2.0-13.8], p = 0.180). Nevertheless, patients with DVT, in comparison to those without, incurred extended hospitalizations (15 [11][12][13][14][15][16][17][18][19][20] vs. 12 [8][9][10][11][12][13][14][15][16], p < 0.001), more complications (3 [2][3][4] vs. 2 [1][2][3], p < 0.001), and higher hospital expenditures (17,940 [12223-27,254] vs. 16,587 [11190-23,502], p = 0.035). Refer to Figure 3 for more detailed information.…”

“…Numerous investigations have underscored the significance of preoperative laboratory assessments in aSAH patients, positing that specific preoperative laboratory parameters can elucidate the pathophysiological trajectory entailed in EBI. Consequently, these metrics hold considerable value in forecasting complications and clinical consequences 5–9 . Hemoglobin (HGB), an intricate protein responsible for oxygen conveyance within erythrocytes, stands as an efficacious indicator of anemia severity 10 .…”