Styliani Bouziana, Konstantinos Tziomalos, Antonios Goulas, Apostolos Ι. Ηatzitolios
Ischemic stroke represents the second commonest cause of death and one of the major causes of disability in the developed world. Patients with a history of stroke have high risk for a recurrent stroke and for other cardiovascular events. Accurate prediction of future events would contribute to effective treatment and reduction in morbidity and mortality. On the other hand, obesity is considered a major cardiovascular risk factor. The adipose tissue exhibits similar properties with other endocrine glands and secrets adipokines, which are cytokines with hormonal action. Adiponectin, leptin and resistin are the most studied adipokines and participate in the pathophysiological mechanisms linking obesity with cardiovascular disease. Measurement of serum adipokines appears to confer incremental value to existing traditional prognostic risk factors for stroke. Moreover, it has been found that the study of single nucleotide polymorphisms (SNPs) of genes that code for adipokines could increase the predictive value of risk factors. SNPs may result in changes in the levels of serum adipokines. Therefore, evaluation of their presence and correlation with the corresponding serum levels are expected to improve the predictive accuracy of existing clinical stroke models contributing to early prevention. In the present review, we summarize the biological role of the adipokines adiponectin, leptin and resistin and the prognostic value of their serum levels in the occurrence and outcome of ischemic stroke. We also discuss the relationship of SNPs of adiponectin, leptin, and the RETN 420C>G polymorphism of resistin in stroke occurrence. The conflicting results of the existing studies make it imperative to further investigate the correlation of these three adipokines with different stroke subtypes.