Neurofilament Light Chain Levels Predict Stroke Risk in Diabetes

Serum neurofilament light chain (NfL) levels can predict incident stroke among middle-aged and older adults with diabetes mellitus, according to a study published in the July issue of Stroke.

Frederick K. Korley, M.D., Ph.D., from the VA Ann Arbor Healthcare System in Michigan, and colleagues performed a case-control study of participants from the Action to Control Cardiovascular Risk in Diabetes trial to determine the discriminative ability of NfL levels for distinguishing between adults with diabetes mellitus who develop incident stroke and those who remain stroke free. Cases developed stroke during a seven-year follow-up period (113 cases); 250 controls were randomly selected participants with no stroke events before or after randomization.

The researchers found that after adjustment for confounding variables, baseline NfL levels were higher in stroke subjects than controls. The hazard ratios for incident stroke were 3.91, 4.05, 5.63, and 9.75 for subjects in the second to fifth quintiles, respectively, relative to subjects in the lowest quintile of NfL levels, after adjustment for race and Framingham Stroke Risk Score. Incorporation of NfL levels into a predictive score comprising race and Framingham Stroke Risk Score increased the C-statistic from 0.71 to 0.78. Overall, 19.2 percent of the variability in baseline NfL levels was explained by cardiovascular disease risk factors.

"While these findings are preliminary, if validated in other studies, we think serum NfL levels could become a central feature of stroke prevention," the authors write.

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