HORMONAL PREDICTORS OF THE COURSE AND OUTCOME OF ISCHEMIC STROKES.
Aim. To study the dynamics of cortisol levels and insulin-like growth factor-1 (IGF) and to assess the effects of these hormones on the course and outcome of ischemic, atherothrombotic, or cardioembolic strokes. Methods. Used was a statistical analysis of the dynamics of cortisol and IGF concentrations in 34 patients admitted to hospital in the early hours since the onset of illness. Depending on the status of carbohydrate metabolism, all patients were divided into three groups: ischemic stroke with no distrubances of carbohydrate metabolism, with stress hyperglycemia and with diabetes mellitus. Results. In patients with stress hyperglycemia, the stress response was excessive, proven by higher levels of cortisol in these patients in the early days of the disease compared with those in patients without disorders of carbohydrate metabolism. Hypercortisolemia was associated with the level of glucose, the volume ischemic focus and the outcome of stroke, suggesting a role of the stress-realizing system in the regulation of carbohydrate metabolism. In patients with diabetes revealed was the relationship between levels of IGF and the factor, complicating the course of ischemic stroke, which natural worsened the outcome of the vascular process. Conclusions. Hypercortisolemia enhances ischemic brain damage, worsening disease outcome in patients with ischemic stroke with stress hyperglycemia, whereas in diabetic patients disturbances of the cortisol metabolism have a less predictive value