Diagnostic value of initial s-100b and neuron- specific enolase levels in diabetic patients with ischemic stroke

Diabetics have a high risk of ischemic stroke. The present study aimed at evaluating
the diagnostic validity of immediate measurements of serum S-100B and Neuron-
Specific Enolase (NSE) in comparison with neurological examinations and cerebral
computed tomography (CT) findings in diabetic ischemic stroke patients. It also
aimed at determining the possible influence of type 2 diabetes mellitus, either or not
complicated with stroke, on serum levels of S-100B and NSE. Another objective of the
current study was the determination of serum malondialdehyde (MDA) as an
indicator of lipid peroxidation (LPO) to detect any possible correlation between LPO
and S-100B or NSE.
This cross sectional study included 66 subjects; 46 diabetic patients and 20 healthy
subjects. Participants were classified into the following groups: Group I: 25 diabetic
patients (type 2) with acute stroke. Group II: 21 uncomplicated controlled type 2
diabetic patients. Group III: 20 apparently healthy age and sex matched control
subjects. Serum levels of S-100B and NSE were assessed by ELIZA technique. MDA
levels were measured using a chemical method. Results of this work showed that the
mean levels of serum S-100B and NSE in diabetic patients with cerebrovascular
stroke were significantly higher than the corresponding mean values in
uncomplicated diabetic patients and in control subjects (P < 0.001). Serum S-100 B
levels in diabetic stroke patients showed significant positive correlation with the
infarct size as assessed by the CT brain ( r = 0.9816 , P < 0.001 ). Similarly, serum
levels of NSE correlated positively with infarct size (r = 0.9384, P < 0.001). No
significant correlation was observed between levels of S-100B and NSE on one hand
and glycemic control and duration of diabetes on the other. Also, MDA showed
statistically significant elevation in diabetics with stroke compared to its
corresponding values in uncomplicated diabetics and control groups (P < 0.001).
In conclusion: Serum levels of S-100B and NSE correlated with the neurological
clinical findings, as well as the infarct size as assessed by brain CT. So, S-100B and
NSE measurements immediately after admission might help to reduce serial CT scans
of the brain of ischemic stroke in diabetic patients. Future studies are recommended
to follow the S-100B and NSE serum levels after thrombolytic therapy. Elevation of
MDA in diabetic patients, which was significantly higher in diabetic patients
complicated with stroke compared to uncomplicated diabetics, might direct the
attention to further studies on the role of antioxidants in such patients.