SAN DIEGO—Postmenopausal women with relatively high serum levels of hepatocyte growth factor (HGF) have an increased risk of ischemic stroke, reported Swapnil N. Rajpathak, MD, and colleagues at the 2009 International Stroke Conference.
The case-control study, nested within the Women’s Health Initiative Observational Study, included postmenopausal women ages 50 to 79 (960 cases and 960 randomly selected, matched controls). “Ischemic stroke was defined as the rapid onset of a persistent neurologic deficit attributed to an obstruction lasting more than 24 hours without evidence for other causes, unless death supervened or there was a demonstrable lesion compatible with acute stroke on CT or MRI scan,” noted Dr. Rajpathak, Assistant Professor in the Department of Epidemiology and Population Health at Albert Einstein College of Medicine, Bronx, New York, and colleagues. Conditional logistic regression analysis was used to determine whether risk of incident ischemic stroke is associated with HGF levels. A multivariable analysis was also performed using the following covariates: smoking, physical activity, use of NSAIDS, use of hypertension medication, systolic and diastolic blood pressure, and diabetes.
HGF levels were positively correlated with many common risk factors for stroke, including age, BMI, diabetes, hypertension, systolic blood pressure, and total and LDL cholesterol. Higher HGF levels were also associated with lower levels of HDL cholesterol, but higher levels of C-reactive protein and homeostatic assessment for insulin resistance (HOMA-IR). “Further, the median HGF levels were higher among cases compared to controls (695.7 vs. 612.0 pg/ml, respectively),” said the investigators.
Odds ratios for incident stroke with increasing quartiles of HGF were 1.0, 1.13, 1.38, and 1.49 in the conditional logistic regression model, which accounted only for the matching factors of age and race/ethnicity. After BMI was added to the model, the association was slightly weakened (OR, 1.44). This association remained significant even after accounting for other important stroke risk factors (OR, 1.33). Further adjustment for C-reactive protein did not impact the results (OR, 1.31).
The secondary analysis did not reveal any evidence for the modification of the association between HGF and stroke risk by obesity, postmenopausal hormone use, HOMA-IR, or physical activity.
Dr. Rajpathak and colleagues recommended that future studies evaluate HGF as a biomarker for established risk factors of stroke and assess its role in the etiopathogenesis of ischemic stroke.
—Laura Sassano