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. 2018 Nov 18;6(11):2067-2072.
doi: 10.3889/oamjms.2018.459. eCollection 2018 Nov 25.

Association between Increased Matrix Metalloproteinase-9 (MMP-9) Levels with Hyperglycaemia Incidence in Acute Ischemic Stroke Patients

Ismail Setyopranoto  1 , Rusdy Ghazali Malueka  1 , Andre Stefanus Panggabean  1 , I Putu Eka Widyadharma  2 , Ahmad Hamim Sadewa  3 , Rusdi Lamsudin  1 , Samekto Wibowo  1
Affiliations

Association between Increased Matrix Metalloproteinase-9 (MMP-9) Levels with Hyperglycaemia Incidence in Acute Ischemic Stroke Patients

Ismail Setyopranoto et al. Open Access Maced J Med Sci. .

Abstract

Background: Hyperglycemia is common in acute stroke patients. Hyperglycemia can induce the production of reactive oxygen species, causing increased activity of matrix metalloproteinase-9 (MMP-9).

Aim: This study aimed to determine an association between the increased levels of MMP-9 and the incidence of hyperglycemia in acute ischemic stroke patients.

Methods: This is a case-control study. Acute ischemic stroke patients admitted to the Stroke Unit of a reference hospital in Yogyakarta, Indonesia was divided into the hyperglycemic and non-hyperglycemic group. Demographic and clinical characteristics of each subject were recorded, and blood levels of MMP-9 were measured. Seventy-one patients were recruited, 40 subjects in the hyperglycemic group and 31 subjects in the non-hyperglycemic group.

Results: The median levels of blood MMP-9 level in the hyperglycemic and non-hyperglycemic group were 974.37 and 748.48 ng/mL, respectively, and the difference was statistically not significant (95% CI, 191.24-2849.53; p = 0.07). When the calculated cut-off point of 600.99 ng/mL was used, the proportion of patients with higher MMP-9 levels was significantly more in the hyperglycemic group compared with the ones in the non-hyperglycemic group (82.5% and 54.8%, respectively; OR = 3.88; p = 0.011).

Conclusion: We concluded that the proportion of patients with MMP-9 level >600.99 ng/mL was significantly higher in acute ischemic stroke patients with hyperglycemia.

Keywords: Acute ischemic stroke; Hyperglycemia; Matrix metalloproteinase-9 (MMP-9).

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Figures

Figure 1
Figure 1
Boxplot distribution of MMP-9 levels in the hyperglycemic and non-hyperglycemic groups. The bottom and top of the box showed the first and third quartiles, while whisker shows the range between + 1.5 Inter Quartile Range (IQR) and the first quartile -1.5 IQR. The median was shown as a horizontal line in the box as well as a number beside the box
Figure 2
Figure 2
Receiver Operating Characteristic (ROC) curve to determine the cutoff point of the MMP-9 levels
See this image and copyright information in PMC

References

    1. A.D Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35:S64–71. https://doi.org/10.2337/dc12-s064 PMid:2218747;2 PMCid: PMC3632174. - PMC - PubMed
    1. Williams LS, Rotich J, Qi R, Fineberg N, Espay A, Bruno A, Fineberg SE, Tierney WR. Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurol. 2002;59:67–71. https://doi.org/10.1212/WNL.59.1.67. - PubMed
    1. Garg R, Chaudhuri A, Munschauer F, Dandona P. Hyperglycemia, insulin, and acute ischemic stroke: a mechanistic justification for a trial of insulin infusion therapy. Stroke. 2006;37:267–73. https://doi.org/10.1161/01.STR.0000195175.29487.30 PMid:16306459. - PubMed
    1. Bevers MB, Vaishnav NH, Pham L, Battey TW, Kimberly WT. Hyperglycemia is associated with more severe cytotoxic injury after stroke. J Cereb Blood Flow Metab. 2016;37:2577–83. https://doi.org/10.1177/0271678X16671730 PMid:27671250 PMCid: PMC5531353. - PMC - PubMed
    1. Uemura S, Matsushita H, Li W, Glassford AJ, Asagami T, Lee KH, Harrison DG, Tsao PS. Diabetes mellitus enhances vascular matrix metalloproteinase activity: role of oxidative stress. Circ Res. 2001;88:1291–8. https://doi.org/10.1161/hh1201.092042 PMid:11420306. - PubMed

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