Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for diagnosis and prognosis
of acute kidney injury and it is also related with cardiovascular disease. However, the relationship between
NGAL and ischemic stroke is not clearly defined. We measured serum NGAL in patients with acute ischemic
stroke and evaluated the relationships with risk factors, stroke severity, outcomes, and other laboratory
parameters.
Methods:We retrospectively reviewed patients with transient ischemic attack or ischemic stroke. We recorded
patient risk factors and laboratory test results at the time of admission and excluded patients with renal
insufficiency to avoid potential effect of kidney function on NGAL concentration. Stroke severity was assessed
using the National Institutes of Health Stroke Scale (NIHSS), and outcome was evaluated using the modified
Rankin Scale (mRS).
Results:The median serum NGAL was 68 ng/mL (interquartile range 51-98). The patients in the high NGAL
group were significantly older and had higher initial NIHSS score and 3 month mRS score than those in the
low NGAL group. We observed significant correlations of NGAL with C-reactive protein, erythrocyte
sedimentation rate, creatinine, blood urea nitrogen, fibrinogen, and homocysteine values. There were no
significant differences in NGAL level between stroke subtypes. Logistic regression analysis revealed that
NGAL concentrations were associated with poor outcome.
Conclusions: Increased NGAL concentration in patients with acute ischemic stroke patients is associated with
stroke severity and poor outcome. Further investigations are needed to determine the precise clinical significance
of NGAL in ischemic stroke.