Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack
Archives of Medical Laboratory Sciences,
Vol. 9 (2023),
15 January 2023
,
Page 1-9 (e3)
https://doi.org/10.22037/amls.v9.39255
Abstract
Background and Aim: Cerebrovascular accident (CVA), also known as stroke, is a vascular syndrome that is the second leading cause of death in the world after ischemic heart disease. Transient ischemic attacks (TIAs) is a warning sign for CVA so that 20% of patients with TIA experience a subsequent stroke within 90 days. Hence, identification of laboratory markers is crucial for the prognosis and diagnosis of patients with CVA and TIA. Changes in some laboratory markers occur in patients with CVA and TIA. Thus, the present study aimed to evaluate hepatic and renal function tests and routine hematological markers in patients with CVA and TIA.
Methods: The present study was a cross - sectional analytical study. The study population was patients with CVA and TIA who were hospitalized in Abadan and Khorramshahr educational hospitals from March 21, 2019, to March 19, 2020. One hundred patients with CVA and one hundred patients with TIA were randomly selected and the necessary information (age, sex, liver enzymes, renal function tests, FBS, and routing hematologic markers including CBC, ESR, PT and PTT) of the patients was collected from HIS (Hospital Information System) of Abadan and Khorramshahr educational hospitals. Liver, kidney and hematologic diagnostic markers were evaluated by age and gender. Data analysis was performed using a t -test (to compare gender difference of laboratory markers in CVA and TIA groups) and one-way ANOVA (to compare laboratory markers among age groups of patients with CVA and TIA). Simple linear regression was used to examine the relationships between changes in FBS (mg / dl) and changes in laboratory diagnostic factors.
Results: The results of this study showed that the highest frequency of patients with CVA (n= 130, 27.3%) and TIA (n= 49, 23.8%) was observed in the age group of 55-64 years. The results indicate that the mean level of some laboratory markers such as FBS (CVA: 174.32 ± 105.83; TIA: 150.32 ± 83.32), creatinine (CVA: 1.37 ± 1.32; 1.42 ± 1.09), LDH (CVA: 696.29 ± 344.90; TIA: 538.17 ± 230.76), and ESR (CVA: 52.41 ± 37.61; TIA: 14.00 ± 8.40) was higher than the normal range in both CVA and TIA. The mean of SGOT (34.10 ± 26.40 IU / L) and ALK (331.44 ± 370.78 IU / L) enzymes were higher than normal only in CVA patients and the mean of SGPT (33.08 ± 38.55 IU / L) was higher than normal only in TIA patients. It was also observed that in patients with CVA, with each unit increase in FBS, a significant increase occurs in K+ level (P < 0.001), WBC (P= 0.003), and RBC (P= 0.031) count, as well as a significant decrease in Na+ level (P= 0.008).
Conclusion: The results of the present study showed an increase in the level of FBS, ESR and LDH both in CVA and TIA. While SGOT and ALK increased only in CVA patients, SGPT showed an increase only in TIA patients.
*First Corresponding Author: Esmat Radmanesh; Email: e.radmanesh@abadanums.ac.ir; ORCID ID: 0000-0003-1369-6580
Second Corresponding Author: Sahar Golabi; Email: s.golabi@abadanums.ac.ir
Please cite this article as: Monfared A, Fadavipour M, Golabi S, Kamyari N, Zahedi A, Hazbenejad A, Kanani K, Jelvay S, Tajvidi M, Radmanesh E. Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack. Arch Med Lab Sci. 2023;9:1-9 (e3). https://doi.org/10.22037/amls.v9.39255
- Stroke
- Transient Ischemic Attack
- Laboratory Markers
- Fasting Blood Sugar
- Creatinine
How to Cite
References
National clinical guidelines for stroke. Royal College of Physicians of London; July 2004: 2nd edition
Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet Neurology. 2017;16(11):877-97.
Sahetapi CM, Aritonang CRL. Differences in blood sugar levels during ischemic stroke and hemorrhagic stroke at RSU UKI Jakarta. International Journal of Medical and Health Research. 2021;7(6):67-76.
Di Napoli M, Papa F, Bocola V. Prognostic influence of increased C-reactive protein and fibrinogen levels in ischemic stroke. Stroke. 2001;32(1):133-8.
Matesin M, Loncaric S, Petravic D, editors. A rule-based approach to stroke lesion analysis from CT brain images. ISPA 2001 Proceedings of the 2nd International Symposium on Image and Signal Processing and Analysis In conjunction with 23rd International Conference on Information Technology Interfaces (IEEE Cat; 2001: IEEE.
Hosseini AA, Sobhani-Rad D, Ghandehari K, Benamer HT. Frequency and clinical patterns of stroke in Iran-Systematic and critical review. BMC neurology. 2010;10(1):1-10.
Borhani-Haghighi A, Safari R, Heydari ST, Soleimani F, Sharifian M, Kashkuli SY, et al. Hospital mortality associated with stroke in southern Iran. Iranian journal of medical sciences. 2013;38(4):314.
Alfieri DF, Lehmann MF, Flauzino T, de Araújo MCM, Pivoto N, Tirolla RM, et al. Immune-Inflammatory, Metabolic, Oxidative, and Nitrosative Stress Biomarkers Predict Acute Ischemic Stroke and Short-Term Outcome. Neurotoxicity research. 2020;38(2).
Sadeghi F, Kovács S, Zsóri KS, Csiki Z, Bereczky Z, Shemirani AH. Platelet count and mean volume in acute stroke: a systematic review and meta-analysis. Platelets. 2020;31(6):731-9.
Muscari A, Collini A, Fabbri E, Giovagnoli M, Napoli C, Rossi V, et al. Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance. BMC Neurol. 2014;14:122.
Morbitzer KA, Jordan JD, Dehne KA, Durr EA, Olm-Shipman CM, Rhoney DH. Enhanced renal clearance in patients with hemorrhagic stroke. Critical care medicine. 2019;47(6):800-8.
Yamamoto Y, Yamamoto N, Kanematsu Y, Kuroda K, Yamaguchi I, Miyamoto T, et al. High white blood cell count is a risk factor for contrast-induced nephropathy following mechanical thrombectomy for acute ischemic stroke. Cerebrovascular Diseases Extra. 2020;10(2):59-65.
Mayda-Domaç F, Misirli H, Yilmaz M. Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2010;19(1):66-72.
An SJ, Yang YJ, Jeon NM, Hong YP, Kim YI, Kim DY. Significantly Reduced Alanine Aminotransferase Level Increases All-Cause Mortality Rate in the Elderly after Ischemic Stroke. International journal of environmental research and public health. 2021;18(9).
Campos F, Rodríguez-Yáñez M, Castellanos M, Arias S, Pérez-Mato M, Sobrino T, et al. Blood levels of glutamate oxaloacetate transaminase are more strongly associated with good outcome in acute ischaemic stroke than glutamate pyruvate transaminase levels. Clinical science (London, England : 1979). 2011;121(1):11-7.
Emsley HC, Smith CJ, Gavin CM, Georgiou RF, Vail A, Barberan EM, et al. An early and sustained peripheral inflammatory response in acute ischaemic stroke: relationships with infection and atherosclerosis. Journal of neuroimmunology. 2003;139(1-2):93-101.
Norris J, Hachinski V, Myers M, Callow J, Wong T, Moore R. Serum cardiac enzymes in stroke. Stroke. 1979;10(5):548-53.
Tonelli M, Curhan G, Pfeffer M, Sacks F, Thadhani R, Melamed ML, et al. Relation between alkaline phosphatase, serum phosphate, and all-cause or cardiovascular mortality. Circulation. 2009;120(18):1784-92.
Ali T, Bath PM, Georgievska-Ismail L. Comparing Blood Pressure and Blood Sugar Level among the Patients with Ischemic Stroke.
Yao M, Ni J, Zhou L, Peng B, Zhu Y, Cui L, et al. Elevated fasting blood glucose is predictive of poor outcome in non-diabetic stroke patients: a sub-group analysis of SMART. PLoS One. 2016;11(8):e0160674.
Capes SE, Hunt D, Malmberg K, Pathak P, Gerstein HC. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke. 2001;32(10):2426-32.
Snarska K, Kapica-Topczewska K, Bachórzewska-Gajewska H, Małyszko J. Renal function predicts outcomes in patients with ischaemic stroke and haemorrhagic stroke. Kidney and Blood Pressure Research. 2016;41(4):424-33.
Muscari A, Collini A, Fabbri E, Giovagnoli M, Napoli C, Rossi V, et al. Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance. BMC neurology. 2014;14(1):1-8.
An SJ, Yang Y-J, Jeon N-m, Hong Y-P, Kim YI, Kim D-Y. Significantly Reduced Alanine Aminotransferase Level Increases All-Cause Mortality Rate in the Elderly after Ischemic Stroke. International journal of environmental research and public health. 2021;18(9):4915.
- Abstract Viewed: 197 times
- PDF Downloaded: 105 times