Adipocytokines and risk of stroke in older people: a nested case-control study

Stott, D.J., Welsh, P.I., Rumley, A., Robertson, M., Ford, I. , Sattar, N.A., Westendorp, R.G.J., Jukema, J.W., Cobbe, S. and Lowe, G.D. (2009) Adipocytokines and risk of stroke in older people: a nested case-control study. International Journal of Epidemiology, 38(1), pp. 253-261. (doi: 10.1093/ije/dyn215)

Abstract

Background Inflammation may play an important role in atherothrombosis and in promoting cerebral damage after stroke. We hypothesized that plasma adipocytokine concentrations would be associated with risk of stroke in older people. Methods Nested case-control study from the Prospective Study of Pravastatin in the Elderly ( PROSPER). Subjects were aged 70-82 years and followed up for a mean of 3.2 years: 266 incident stroke cases ( 179 confirmed as ischaemic) were compared with 532 controls matched for age, gender and treatment allocation ( pravastatin or placebo). Adipocytokines [ adiponectin, interleukin- (IL-)18 and tumour necrosis factor (TNF)alpha] were measured on stored baseline plasma samples. Results Elevated plasma adiponectin was associated with lower risk of ischaemic stroke on univariate analysis: odds ratio ( OR) 0.78 per 1 SD increase (95% CI 0.62-0.97). There were no associations of IL- 18 or TNF alpha with risk for ischaemic or total strokes. In multivariate models the independent predictors of ischaemic stroke were prior cerebrovascular accident ( OR 2.68, 95% CI 1.60-4.50), any alcohol use (1.98, 1.33-2.94), triglycerides (1.40, 1.11-1.77), Barthel score (0.75, 0.58-0.96) and known diabetes (1.72, 1.04-2.83); adiponectin, IL- 18 and TNFa did not contribute. A similar pattern of risk was seen for total stroke. Conclusions Reduced adiponectin may have a modest role in the aetiology of ischaemic stroke in older people, however IL- 18 and TNFa are unlikely to play any important part. These adipocytokines do not have clinical predictive utility; history of prior cerebrovascular accident, known diabetes mellitus, prior disability and higher alcohol intake explain much of the stroke risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Welsh, Professor Paul and Robertson, Mrs Michele and Stott J, Professor David and Ford, Professor Ian and Rumley, Dr Ann and Lowe, Professor Gordon and Cobbe, Professor Stuart and Sattar, Professor Naveed
• Authors: Stott, D.J., Welsh, P.I., Rumley, A., Robertson, M., Ford, I., Sattar, N.A., Westendorp, R.G.J., Jukema, J.W., Cobbe, S., and Lowe, G.D.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: International Journal of Epidemiology
• Publisher: Oxford University Press
• ISSN: 0300-5771
• ISSN (Online): 1464-3685
• Published Online: 24 October 2008