Plasma Glutamine and Glutamate in Relation to Clinical Outcomes After Ischemic Stroke: A Multicenter Prospective Study.
Shengkai Qin, Ming Wang, Yanyu Zhu et al.
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In 30 seconds
This secondary analysis of the multicenter CATIS study examined plasma glutamine (Gln), glutamate (Glu), and their ratio (GGR) in 3499 patients with ischemic stroke. Levels measured within 24 hours of admission were assessed in relation to clinical outcomes at 3 months. Compared with the lowest quartiles, the highest quartiles of Gln and GGR were associated with lower odds of death or major disability (adjusted odds ratios 0.37 [95% CI, 0.28-0.47] and 0.37 [95% CI, 0.29-0.48]); the highest Glu quartile was associated with higher odds (2.05 [95% CI, 1.60-2.62]).
Key findings
- Highest versus lowest Gln quartile was associated with lower odds of death or major disability at 3 months: adjusted odds ratio 0.37 (95% CI, 0.28-0.47).
- Highest versus lowest Glu quartile was associated with higher odds of the primary outcome: adjusted odds ratio 2.05 (95% CI, 1.60-2.62).
- Highest versus lowest GGR quartile was associated with lower odds of the primary outcome: adjusted odds ratio 0.37 (95% CI, 0.29-0.48).
- Adding the metabolites to conventional risk models increased C statistics from 0.831 to 0.842-0.848 for unfavorable functional outcome.
Why it matters
These findings suggest that early plasma Gln, Glu, and GGR may help characterize prognosis after ischemic stroke. Their association with 3-month functional outcome, and the reported improvement in model discrimination, support further evaluation of these metabolites as prognostic markers. The results do not establish that changing metabolite levels would improve outcomes.
What to keep in mind
This was a secondary analysis of an existing study, and the reported associations do not establish causality.