China: Findings from a meta-analysis published in Neuroscience & Biobehavioral Reviews showed that higher peripheral blood glucose levels in the acute phase of stroke raise post-stroke depression (PSD) risk. Also, hemoglobin A1c (HbA1c) was found to be a better biomarker than fasting plasma glucose (FPG) for post-stroke depression risk.
A stroke is defined as a sudden blood supply loss to the brain resulting in permanent tissue damage caused by thrombotic, embolic, or hemorrhagic events. Post-stroke depression is a common psychiatric disorder that impacts patients' neurological recovery after a stroke. There is a requirement for particular biomarkers to predict post-stroke depression. Many previous studies have shown diabetes to be a predictor of post-stroke depression. However, there remains controversy on whether increased levels of FPG and HbA1c are tied to an elevated PSD risk.

Shaokuan Fang, Department of Neurology, Neuroscience Centre, the First Hospital of Jilin University, Changchun, China, and colleagues comprehensively searched databases for eligible studies. The relationship between peripheral blood glucose levels during the acute phase of stroke and PSD risk was examined using standard mean differences. When appropriate unadjusted or adjusted odds ratio (ORs) were available narrative syntheses and meta-analyses were conducted. The analysis included a total of 21 prospective cohort studies.
The study led to the following findings:
PSD patients had significantly higher peripheral blood glucose levels than non-PSD patients (FPG: SMD, 0.28, HbA1c: SMD, 0.49 respectively).
In the subgroup analyses by classifying the time point of depression assessment, HbA1c was more statistically significantly associated with the risk of PSD than FPG.
Differences in the prevalence of diabetes were not heterogeneity sources.
"Higher peripheral blood glucose levels in the acute phase of stroke increase PSD risk," the researchers of the study wrote in their conclusion. "HbA1c might be a superior biomarker for the risk of PSD than FPG."
Fasting plasma glucose and hemoglobin A1c are both important potential predictors of post-stroke depression, the authors noted.
Reference:
Wang Y, Zhu L, Tan X, Cheng Y, Wang X, Fang S. Higher levels of peripheral blood glucose in the acute stage of stroke increase the risk of Post-stroke Depression: A Systematic Review and Meta-Analysis. Neurosci Biobehav Rev. 2022 Aug 12:104829. doi: 10.1016/j.neubiorev.2022.104829. Epub ahead of print. PMID: 35970415.