The effect of insulin resistance on inflammatory response and oxidative stress in acute cerebral ischemia.

OBJECTIVE: Insulin resistance (IR) has effects on inflammation and oxidative stress which have importance in acute stroke. Our aim was to investigate the relationships between IR, inflammation, oxidative stress and stroke severity in acute ischemic stroke patients.

METHODS: We examined the relationships between inflammation, oxidative stress and stroke severity in 75 acute stroke patients with and without IR. Serum levels of oxidative stress markers (nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH)) were measured as well as the cytokines interleukin-6 (IL-6) and interleukin-10 (IL-10).

RESULTS: The levels of IL-10 (13.7±19.11 vs 51.20±89.32 pg/ml, p<0.00) in IR group were significantly reduced. Patients with IR had higher levels of NO (30.26±17.63 vs 22.57±14.5 µmol/L, p=0.04) and IL6 (27.44±57.13 vs 8.68±11.8 pg/ml, p<0.00) and higher NIHSS scores (11.40±5.35 vs 8.81±5.76, p=0.04) when compared with noninsulin resistant group. IL-10 was found negatively correlated with HOMA. Additionally, the parameters with positive correlations with HOMA were NIHSS, IL-6 and NO.

CONCLUSIONS: Inflammation and oxidative stress are more evident in acute stoke patients with insulin resistance which may cause worse stroke severity. Our data also suggest that IL-10 as an antiinflammatory cytokine can be much lower in insulin resistance in acute phase of ischemic stroke. However it can be elevated as an adaptive mechanism in metabolic syndrome as a chronic condition.

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