Plasma adiponectin as an independent predictor of early death after acute intracerebral hemorrhage.

Background: Hyperadiponectinemia or hypoadiponectinemia is associated with different diseases. There is a paucity of data on circulating plasma adiponectin concentrations in human intracerebral hemorrhage (ICH). We investigated the plasma adiponectin concentrations in patients with intracerebral hemorrhage, and analyzed the correlation of adiponectin with the severity of brain injury and early mortality after ICH.

Methods: Thirty controls and 86 patients with acute ICH were included. Plasma samples were obtained on admission and at days 1, 2, 3, 5, and 7 after ICH. Their concentrations were measured by enzyme-linked immunosorbent assay.

Results: After ICH, plasma adiponectin level of the patients increased immediately within 6h, peaked within 24h, plateaued at day 2, and decreased gradually thereafter. It was substantially higher than that in the controls in a period of 7 days. A multivariate analysis showed plasma adiponectin level was an independent predictor for 1-week mortality (odds ratio, 1.199; 95% CI: 1.035-1.389; P=0.015) and that it was associated with Glasgow coma scale (GCS) score (t=-3.596, P=0.001) and plasma C-reactive protein level (t=4.194, P<0.001). A receiver operating characteristic curve identified that a plasma adiponectin level >16.4 μg/ml predicted the 1-week mortality of patients with a sensitivity of 65.6% and a specificity of 90.7% (AUC, 0.789; 95% CI: 0.688-0.870). The predictive value of adiponectin concentration was significantly lower than that of GCS score (P=0.007) and hematoma volume (P=0.022). Adiponectin could not improve the predictive values of GCS score (P=0.317) and hematoma volume (P=0.226).

Conclusions: Adiponectin is an independent indicator of early death and may play an anti-inflammatory role after intracerebral hemorrhage.