Chronic Hyperglycemia before Spinal Cord Injury Increases Inflammatory Reaction and Astrogliosis after Injury: Human and Rat Studies

Traumatic spinal cord injury (SCI) can cause permanent disabilities that seriously reduce quality of life. We evaluated the effects of chronic hyperglycemia before SCI on inflammatory markers and functional recovery after SCI in human patients and a rat model. In the human study, multivariate logist...

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Published inJournal of neurotrauma Vol. 37; no. 9; pp. 1165 - 1181
Main Authors Park, Ki-Su, Kim, Jin Bum, Keung, Martin, Seo, Ye Jin, Seo, Sung Young, Mun, Seul Ah, Lee, Young-Seok, Cho, Dae-Chul, Hwang, Jeong-Hyun, Han, Inbo, Kim, Chi Heon, Kim, Kyoung-Tae
Format Journal Article
LanguageEnglish
Published United States Mary Ann Liebert, Inc 01.05.2020
Subjects
Aneurysms
Cerebrospinal fluid
Diabetes
Free radicals
Gliosis
Glucose
Hemoglobin
Hospitals
Hyperglycemia
Inflammation
Insulin
Interleukin 8
Laboratories
Magnetic resonance imaging
Quality of life
Recovery of function
Risk factors
Spinal cord injuries
Trauma
Minneapolis Minnesota
United States > US
Germany
SCI
hyperglycemia
gliosis
inflammation
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Summary:Traumatic spinal cord injury (SCI) can cause permanent disabilities that seriously reduce quality of life. We evaluated the effects of chronic hyperglycemia before SCI on inflammatory markers and functional recovery after SCI in human patients and a rat model. In the human study, multivariate logistical regression analysis revealed that hemoglobin A1c (HbA1c) values, reflecting average plasma glucose concentration over a 3 month period, at admission were a significant risk factor for poor functional recovery. Moreover, patients with chronic hyperglycemia (HbA1c ≥ 6.5%) had high concentrations of inflammatory biomarkers (interleukin [IL]-6 and IL-8) of cerebrospinal fluid after SCI. Consistent with patient findings, chronic hyperglycemia before SCI in rats was associated with increased inflammatory responses and oxygen-free radicals in the spinal cord and blood, thus resulting in poor functional recovery and histological outcomes. Tight glucose control before SCI decreased the harmful effects of hyperglycemia after SCI in both human and rat studies. Our findings suggest that chronic hyperglycemia before SCI may be a significant prognostic factor with a negative impact on functional and histological outcomes, highlighting the importance of tight glucose control before SCI.
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ISSN:0897-7151
1557-9042
DOI:10.1089/neu.2019.6724