Adhesion Molecules (sICAM and sVCAM) and Cerebrovascular Risk Factors in Old Cerebrovascular Ischemic Stroke

Background and Objectives: The role of inflammation and inflammatory markers in the pathogenesis of stroke and atherosclerosis is increasingly appreciated. The conventional stroke risk factors, including hypertension, diabetes mellitus and smoking induce endothelial dysfunction, cell injury, and a proinflammatory environment with upregulation of adhesion molecules and proinflammatory cytokines.Aim: To detect the relation between the Adhesion Molecules (sICAM and sVCAM) and conventional cerebrovascular risk factors.Patients and Methods: We enrolled 30 patients with old cerebrovascular ischemic stroke and 30 age and sex matched volunteers as controls. Patients were evaluated clinically, emphasized on cerebrovascular risk factors such as: Obesity, hypertension, diabetes, dyslipidemia and smoking. Obesity was assessed by measuring Body-Mass Index and waist circumference. All patients and controls were subjected to full history, clinical examination and laboratory investigations including complete blood picture, the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fasting and 2 hours pp blood sugar level, Lipid profile (serum triglycerides, cholesterol, HDL and LDL), uric acid, urine analysis and PT, PC and INR. Serum concentrations of sVCAM and sICAM were determined by means of quantitative enzyme immunoassay.Results: The most prevalent risk factor among patients with atherosclerotic ischemic stroke was Hypertension (70%) followed by Dyslipidemia (63%), Obesity (50%), Smoking (43%) and Diabetes (43%). The level of sVCAM was significantly related to obesity detected by the waist circumference (and not BMI) which points to the association between increased levels of AM and abdominal fat rather than total body mass. Higher levels of both adhesion molecules were detected in patients who smoked, which adds to the mechanisms by which smoking promotes its adverse effects on the vascular system.Conclusion: We concluded that levels of sICAM and sVCAM were influenced by obesity (increased waist circumference) and smoking which are important vascular risk factors in ischemic cerebrovascular stroke.