Correlation of Oxidative Stress Parameters and Inflammatory Markers in Ischemic Stroke Patients

Background: Ischemic stroke (IS) usually initiates inflammation and oxidative stress leading to neuronal death. Diabetes and impaired fasting glucose are associated with incidence of cerebrovascular and cardiovascular diseases. Methods: In the present study, we assessed the relationship of fasting glucose with antioxidative parameters (erythrocyte glutathione peroxidase [GPx] and superoxide dismutase [SOD] activities) and inflammatory markers (high-sensitivity C-reactive protein [hs-CRP] and fibrinogen) in IS patients with and without type 2 diabetes mellitus (T2DM). In addition, we determined factors associated with the risk of IS among these patients. Antioxidative, inflammatory, and lipid parameters were measured in 196 patients with IS (117diabetics and 79 nondiabetics). Results: After adjustment of covariates, multiple logistic regression analysis showed that SOD and GPx significantly decreased the risk of IS among patients with and without T2DM. However, hs-CRP increased the risk of IS. For the diabetic patients, fasting glucose was positively correlated with hs-CRP and fibrinogen and was negatively correlated with GPx and SOD levels. In addition, fasting glucose and hemoglobin A1c or glycosylated hemoglobin (HbA1c) have been shown to increase the risk of IS in diabetic patients. Conclusions: These data suggest that the antioxidant activity of plasma may be an important factor that provides protection from IS. hs-CRP concentrations can be used as a clinical screening tool to identify individuals with higher risk of IS. Finally, fasting glucose and HbA1c may also be useful indicators for cerebrovascular risk in diabetic patients that may be mediated by low levels of antioxidative defense markers and high inflammation status.