Utility of serum macrophage migration inhibitory factor as a potential biomarker for detection of cerebrocardiac syndrome following severe traumatic brain injury

Clin Chim Acta. 2021 Jan;512:179-184. doi: 10.1016/j.cca.2020.11.007. Epub 2020 Nov 9.


Background: Cerebrocardiac syndrome (CCS) is a common complication after severe traumatic brain injury (sTBI) and its occurrence obviously increases the risk of a poor outcome. Macrophage migration inhibitory factor (MIF) acts as an inflammatory cytokine and its circulating concentration are related to acute heart and brain injury. The aim of this study was to examine the association of serum concentration of MIF with posttraumatic CCS.

Methods: From January 2016 to February 2019, 116 sTBI patients and 116 healthy controls with similar age and gender percentage were recruited. Relationship between serum MIF concentration and CCS was assessed using multivariate analysis.

Results: Serum MIF concentration of patients were significantly higher than those among controls. Serum MIF concentration were intimately correlated with Glasgow coma scale scores (t = -5.553, P < 0.001) and serum C-reactive protein concentration (t = 5.320, P < 0.001) in a multivariate linear regression model. 61 patients (52.6%) displayed CCS. Under ROC curve analylsis, there was a strong discriminatory ability for CCS regarding serum MIF concentration (area under curve, 0.834; 95% confidence interval, 0.754-0.897). Serum MIF concentration were highly associated with CCS independent of other confounding factors (odds ratio, 5.608; 95% CI: 1.896-16.587).

Conclusions: Increased MIF in serum may be a useful biomarker for early detection of CCS after head trauma.

Keywords: Biomarkers; Cerebrocardiac syndrome; Inflammation; Macrophage migration inhibitory factor; Traumatic brain injury.

MeSH terms

  • Biomarkers
  • Brain Injuries, Traumatic* / complications
  • Brain Injuries, Traumatic* / diagnosis
  • C-Reactive Protein
  • Humans
  • Macrophage Migration-Inhibitory Factors*


  • Biomarkers
  • Macrophage Migration-Inhibitory Factors
  • C-Reactive Protein