Relationship between serum neutrophil gelatinase-associated lipocalin levels and cognitive impairment, anxiety, and depressive symptoms in acute ischemic stroke

Table 1 Baseline characteristics of the study population stratified by the presence or absence of cognitive impairment, anxiety, and depressive symptoms

Characteristic	Cognitive impairment		P value	Anxiety		P value	Depressive symptoms		P value
	Yes (n = 52)	No (n = 98)		Yes (n = 42)	No (n = 108)		Yes (n = 48)	No (n = 102)
Age, year, mean ± SD	68.3 ± 9.5	63.8 ± 10.3	0.010	66.9 ± 9.8	64.8 ± 10.3	0.261	67.5 ± 9.6	64.4 ± 10.3	0.083
Male, n (%)	28 (53.8)	59 (60.2)	0.448	22 (52.4)	65 (60.2)	0.379	25 (52.1)	62 (60.8)	0.312
BMI, kg/m2, mean ± SD	24.8 ± 3.2	24.3 ± 3.1	0.356	24.5 ± 3.3	24.5 ± 3.1	0.980	24.6 ± 3.2	24.4 ± 3.1	0.720
Smoking, n (%)	18 (34.6)	30 (30.6)	0.614	15 (35.7)	33 (30.6)	0.540	17 (35.4)	31 (30.4)	0.534
Hypertension, n (%)	37 (71.2)	61 (62.2)	0.273	29 (69.0)	69 (63.9)	0.548	33 (68.8)	65 (63.7)	0.544
Diabetes, n (%)	19 (36.5)	28 (28.6)	0.311	15 (35.7)	32 (29.6)	0.472	18 (37.5)	29 (28.4)	0.262
Dyslipidemia, n (%)	28 (53.8)	46 (46.9)	0.415	22 (52.4)	52 (48.1)	0.639	25 (52.1)	49 (48.0)	0.637
Previous stroke, n (%)	10 (19.2)	14 (14.3)	0.417	8 (19.0)	16 (14.8)	0.522	9 (18.8)	15 (14.7)	0.523
NIHSS score at admission, median (interquartile range)	8 (5-12)	5 (3-9)	0.001	7 (4-11)	6 (3-9)	0.118	8 (4-12)	5 (3-9)	0.007

BMI: Body mass index; NIHSS: National Institutes of Health Stroke Scale.

Table 2 Serum neutrophil gelatinase-associated lipocalin levels at admission in patients with and without cognitive impairment, anxiety, and depressive symptoms

Neuropsychiatric complication	Serum NGAL levels (ng/mL)		P value
	Yes	No
Cognitive impairment, median (interquartile range)	5.6 (4.2-7.1)	3.2 (2.4-4.3)	< 0.001
Anxiety, median (interquartile range)	5.1 (3.8-6.6)	3.5 (2.6-4.7)	0.002
Depressive symptoms, median (interquartile range)	5.4 (4.0-6.9)	3.3 (2.5-4.5)	< 0.001

NGAL: Neutrophil gelatinase-associated lipocalin.

Table 3 Multivariate logistic regression analysis of the association between serum neutrophil gelatinase-associated lipocalin levels and neuropsychiatric comorbidities

Outcome	Odds ratio (95%CI)	P value
Cognitive impairment	1.42 (1.18-1.71)	< 0.001
Anxiety	1.28 (1.09-1.51)	0.003
Depressive symptoms	1.39 (1.16-1.67)	< 0.001

Adjusted for age, sex, body mass index, smoking status, hypertension, diabetes mellitus, dyslipidemia, previous stroke, and National Institutes of Health Stroke Scale score at admission. CI: Confidence interval.

Table 4 Discriminative ability of serum neutrophil gelatinase-associated lipocalin levels for predicting cognitive impairment, anxiety, and depressive symptoms using receiver operating characteristic curve analysis

Neuropsychiatric complication	AUC (95%CI)	Optimal cut-off value (ng/mL)	Sensitivity (%)	Specificity (%)
Cognitive impairment	0.78 (0.71-0.85)	4.2	75.0	70.4
Anxiety	0.67 (0.58-0.76)	4.0	66.7	63.0
Depressive symptoms	0.71 (0.63-0.79)	4.1	70.8	65.7

AUC: Area under the receiver operating characteristic curve; CI: Confidence interval.