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Observational Study
. 2023 Feb 13;24(4):3746.
doi: 10.3390/ijms24043746.

Influence of Temperature Chronobiology on Stroke Outcome

Maria Luz Alonso-Alonso  1 , Ana Sampedro-Viana  1 , Manuel Rodríguez-Yáñez  2 , Iria López-Dequidt  2 , José M Pumar  1   3 , Antonio J Mosqueira  1   3 , Sabela Fernández-Rodicio  1 , Marcos Bazarra-Barreiros  1 , Tomás Sobrino  4 , Francisco Campos  5 , José Castillo  1 , Pablo Hervella  1 , Ramón Iglesias-Rey  1
Affiliations
Observational Study

Influence of Temperature Chronobiology on Stroke Outcome

Maria Luz Alonso-Alonso et al. Int J Mol Sci. .

Abstract

The circadian system regulates numerous physiological variables, including body temperature. Additionally, a circadian patter has been described in stroke onset. Considering this, we hypothesised that the chronobiology of temperature may have an impact on stroke onset and functional outcomes. We also studied the variation of blood biomarkers according to stroke onset time. This is a retrospective observational study. Of the patients included, 2763 had a stroke between midnight and 8:00 h; 1571 between 8:00-14:00 h; and 655 between 14:00 h and midnight. Axillary temperature was measured at admission. At this time, blood samples were collected for biomarker analysis (TNF-α, IL-1β, IL-6, IL-10, and glutamate). Temperature was higher in patients admitted from 8:00 h to midnight (p < 0.0001). However, the percentage of poor outcome at 3 months was highest in patients from midnight to 8:00 h (57.7%, p < 0.001). The association between temperature and mortality was highest during night time (OR: 2.79; CI 95%: 2.36-3.28; p < 0.001). These patients exhibited high glutamate (220.2 ± 140.2 µM), IL-6 (32.8 ± 14.3 pg/mL) and low IL-10 (9.7 ± 14.3 pg/mL) levels. Therefore, temperature chronobiology could have a significant impact on stroke onset and functional outcome. Superficial body hyperthermia during sleep seems to be more dangerous than during wakefulness. Further studies will be necessary to confirm our data.

Keywords: chronobiology; circadian rhythm; functional outcome; stroke; temperature.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient screening.
Figure 2
Figure 2
Relationship between stroke time and (a) time to emergency care and (b) age with respect to gender.
Figure 3
Figure 3
Relationship between stroke time and (a) type of stroke, (b) gender and etiology of (c) ischemic stroke and (d) intracerebral haemorrhage.
Figure 4
Figure 4
Relationship between temperature at admission and (a) stroke time, (b) outcome at 3 months with respect to age. (c) Relationship between temperature at admission and outcome at 3 months and (d) percentage of poor outcome at 3 months both with respect to stroke time.
Figure 5
Figure 5
(a) Relationship between temperature at admission and modified Rankin scale at 3 months. Relationship between stroke time and (b) plasma glutamate and (c) cytokines at admission.
See this image and copyright information in PMC

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