Serum Dickkopf-1 levels and poststroke depression in ischemic stroke patients

Kaixin Zhang; Zhengbao Zhu; Mengyao Shi; Daoxia Guo; Yang Liu; Xiaoqing Bu; Bizhong Che; Tian Xu; Pinni Yang; Jing Chen; Tan Xu; Jiang He; Yonghong Zhang

doi:10.1016/j.jad.2022.05.040

Serum Dickkopf-1 levels and poststroke depression in ischemic stroke patients

J Affect Disord. 2022 Aug 1:310:337-342. doi: 10.1016/j.jad.2022.05.040. Epub 2022 May 10.

Authors

Kaixin Zhang¹, Zhengbao Zhu¹, Mengyao Shi², Daoxia Guo¹, Yang Liu³, Xiaoqing Bu⁴, Bizhong Che¹, Tian Xu⁵, Pinni Yang¹, Jing Chen⁶, Tan Xu¹, Jiang He⁶, Yonghong Zhang⁷

Affiliations

¹ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
² Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
³ Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, China.
⁴ Department of Epidemiology, School of Public Health and Management, Chongqing Medical University, Chongqing, China.
⁵ Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China.
⁶ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
⁷ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Electronic address: yhzhang@suda.edu.cn.

PMID: 35561890
DOI: 10.1016/j.jad.2022.05.040

Abstract

Background: Serum Dickkopf-1 (Dkk-1) levels are associated with poor ischemic stroke prognosis, although their impact on poststroke depression (PSD) remains unclear. This study aimed to examine the association between serum Dkk-1 levels and PSD.

Methods: Serum Dkk-1 levels were measured in 564 patients with ischemic stroke who participated in the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The patients' depression status at 3 months after stroke was assessed using the Hamilton Rating Scale for Depression (HRSD-24). The HRSD score cutoff point for the diagnosis of depression was ≥8.

Results: A total of 224 (39.72%) patients were categorized as having PSD 3 months after ischemic stroke. After adjusting for potential confounders, including age, sex, and other important covariates, elevated Dkk-1 levels were associated with an increased risk of PSD (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.14-3.22; P_trend = 0.037). Similarly, each standard deviation (SD) increase in log-transformed Dkk-1 levels was associated with a 24% increased risk of PSD (OR, 1.24; 95% CI, 1.03-1.49; P = 0.025). Subgroup analyses further confirmed the significant associations between Dkk-1 levels and PSD.

Conclusion: Higher serum Dkk-1 levels at baseline are independently associated with an increased risk of PSD at 3 months after stroke, suggesting that Dkk-1 levels may be a promising prognostic biomarker for PSD.

Limitations: This study measured serum Dkk-1 levels only in the acute phase of stroke not in different phases; therefore, the relationship between dynamic changes in Dkk-1 levels and PSD could not be evaluated.

Keywords: Biomarker; Dickkopf-1; Ischemic stroke; Poststroke depression.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Ischemia* / complications
Depression / diagnosis
Humans
Ischemic Stroke*
Risk Factors
Stroke* / complications