Blood levels of glutamate oxaloacetate transaminase are stronger associated with good outcome in acute ishcemic stroke than glutamate pyruvate transaminase
Résumé
ABSTRACT Ischemic stroke is associated with an excessive release of glutamate in brain. Glutamate-oxaloacetate transaminase (GOT) and glutamate-pyruvate transaminase (GPT) are two enzymes that are able to metabolize blood glutamate facilitating the lowering of extracellular levels of brain glutamate. Our aim was to study the association between blood levels of both enzymes and stroke outcome in the patients with acute ischemic stroke. We prospectively studied 365 patients with first ischemic stroke <12 hours. Glutamate, GOT and GPT levels were determined in blood samples obtained at admission. We considered functional outcome at 3 months (good outcome: mRS ≤2; poor outcome mRS <2), early neurological deterioration (END) in the first 72 h (Increment ≥4 points in NIHSS) and infarct volume (CT at 36-72h) as end-points. We have found an inverse correlation between GOT and GPT levels and blood glutamate levels. Patients with poor outcome showed lower levels of GOT (11.9±8.2 vs. 22.7±10.2 mU/mL, p<0.0001) and GPT (19.5±14.3 vs. 24.7±20.3 mU/mL, p=0.004). A negative correlation has been found between GOT (Pearson coefficient = -0.477, p<0.0001) and GPT (Pearson coefficient = -0.116, p=0.027) levels and infarct volume. Patients with END showed higher levels of blood glutamate (381.7±97.9 vs. 237.6±114.0 μmol/L, p<0.0001) and lower levels of GOT (10.8±6.7 vs. 18.1±10.8 mU/mL, p<0.0001). This clinical study shows an association between high blood GOT and GPT levels with good outcome in ischemic stroke patients, being this association stronger for GOT than GPT levels.
Domaines
Médecine humaine et pathologie
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