Background:
Limited studies concern the influence of obesity-induced dysregulation of
adipokines in functional recovery after stroke neurorehabilitation.
Objective:
To investigate the relationship between serum leptin, resistin, and adiponectin and functional
recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential
significance as prognostic markers of rehabilitation outcomes was also verified.
Methods:
Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen
obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially
available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed
before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale
(mRS), and Functional Independence Measure (FIM).
Results:
Compared to controls, higher leptin and resistin values and lower adiponectin values were
observed in stroke patients before neurorehabilitation and no correlations were found between adipokines
and clinical outcome measures. Neurorehabilitation was associated with improved scores of
BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and
resistin together increased adiponectin were detected in stroke patients, while leptin decreased but
not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome
measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score,
and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated
with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified
leptin as prognostic factor for BI, mRS, and FIM.
Conclusions:
Our data show the effectiveness of neurorehabilitation in modulating adipokines levels
and suggest that leptin could assume the significance of biomarker of functional recovery.
