Evaluation of the relationship between serum HIF-1α ve NRF-2 levels and functional status in patients with hemiplegia following a cerebrovascular event

This study aims to evaluate the relationship between serum Hypoxia-Inducible Factor-1 alpha (HIF-1α) and Nuclear Factor Erythroid 2-Related Factor 2 (NRF-2) levels and functional status in patients diagnosed with hemiplegia following a cerebrovascular event (CVE). A total of 53 patients who were newly diagnosed with hemiplegia after a first-time CVE and 54 healthy volunteers who did not meet exclusion criteria were included in the study. Participants were recruited between August 1, 2023, and August 1, 2024, at the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Adnan Menderes University. Written informed consent was obtained from all participants, and demographic data, medical history, and clinical evaluations were recorded. In the patient group, the Functional Independence Measure (FIM) and Brunnstrom Motor Staging were assessed, and serum HIF-1α and NRF-2 levels were measured using the ELISA method. There were no significant differences between the groups in terms of age, sex, height, body weight, and BMI (p > 0.05). The amount of cigarette consumption was significantly higher in the patient group among smokers (p = 0.032). Serum HIF-1α and NRF-2 levels were significantly elevated in the patient group compared to the control group (p = 0.031 and p = 0.013, respectively). In the healthy group, a negative correlation was observed between NRF-2 levels and BMI (p = 0.019). A positive correlation was identified between cigarette consumption and HIF-1α levels (p = 0.025). Serum NRF-2 levels showed a positive correlation with Brunnstrom stages (p < 0.05). When early, middle, and late post-stroke periods were compared, no significant differences were found in HIF-1α and NRF-2 levels, Brunnstrom stages, or FIM scores (p > 0.05). In this study, serum HIF-1α and NRF-2 levels were found to be significantly higher in the patient group compared to the control group. While no significant association was found between HIF-1α levels and functional recovery, NRF-2 levels were associated with motor improvement. These findings suggest that functional recovery after stroke may potentially be supported by biomarker-based approaches, warranting further research.