Leptin/adiponectin ratio predicts poststroke neurological outcome

Background and aims Different adipokines have been associated with atherosclerotic plaque rupture and cardiovascular events, such as acute ischaemic stroke ( AIS ). However, the potential role of these molecules in postischaemic brain injury remains largely unknown. Methods and methods We performed a substudy analysis on nonobese patients with first atherothrombotic stroke ( n = 35) from a recently published prospective cohort. Primary endpoint was to investigate the predictive value of serum leptin/adiponectin ratio on neurological recovery at 90 days after AIS . The secondary endpoint was the predictive value of serum adipokine levels of clinical and radiological outcomes at a shorter follow‐up (at days 1 and 7 after AIS ). The radiological evaluation included ischaemic lesion volume and haemorrhagic transformation ( HT ). The clinical examination was based on National Institutes of Health Stroke Scale ( NIHSS ) and modified Rankin Scale ( mRS ). Results At day 1 after AIS , serum leptin and leptin/adiponectin ratio were increased and inversely correlated with both radiological and clinical parameters at all follow‐up time points. Once identified the best cut‐off points by receiver operating characteristic ( ROC ) analysis, risk analysis showed that higher circulating leptin improved neurological recovery at day 90. In addition, leptin/adiponectin ratio maintained statistical significance after adjustment for age, gender and thrombolysis, also predicting the occurrence of HT in the first 7 days after AIS (adjusted OR 0·15 [95% CI 0·03–0·83); P = 0·030]). Conclusions Higher leptin/adiponectin ratio at day 1 predicted better neurological outcomes in patients with atherothrombotic AIS and might be potentially useful as a prognostic biomarker of the disease.