• Tomasz Dziedzic, Joanna Pera, Marcin Wnuk, Andrzej Szczudlik, and Agnieszka Slowik.
• Department of Neurology, Collegium Medicum, Jagiellonian University, Krakow, Poland. Dziedzic@cm-uj.krakow.pl
• Atherosclerosis. 2012 Mar 1; 221 (1): 212-4.

ObjectiveAnimal studies demonstrated that protein malnutrition increases pituitary-adrenorcortical activity and leads to excessive cortisol release. The aim of our study was to determine the association between serum albumin and cortisol level in patients with acute ischemic stroke.MethodsFifty-nine patients with first-ever ischemic stroke were included. Serum albumin level was measured within 36 h after stroke symptoms onset. Serum cortisol was measured between 36 and 72 h after stroke onset at 6 a.m., 10 a.m., 6 p.m. and 10 p.m.ResultsThe patients in upper tertile of serum albumin had significantly lower cortisol level measured at 6 a.m. (median with interquartiles: 549.0 [430.4-667.7] nmol/L vs 590.4 [482.8-918.7] nmol/L, P=0.047) and 10 a.m. (402.8 [344.9-510.4] nmol/L vs 634.6 [482.8-827.7] nmol/L, P<0.01) than patients in lower and middle tertiles. On logistic regression analysis adjusted for age and stroke severity, patients in lower and middle tertile of serum albumin had about 7-times higher risk of hypercortisolemia than patients in upper tertile (P<0.01).ConclusionsLow serum albumin level in patients with ischemic stroke is associated with higher serum cortisol level and predisposes to hypercortisolemia.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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