Clinical Utility of the Serum Level of Lipoprotein-Related Phospholipase A2 in Acute Ischemic Stroke With Cerebral Artery Stenosis

被引:9
作者
Cao, Jing [1 ]
Yan, Ping [1 ]
Zhou, Yajun [1 ]
Zhou, Xia [1 ]
Sun, Zhongwu [1 ]
Zhu, Xiao-Qun [1 ]
机构
[1] Anhui Med Univ, Dept Neurol, Affiliated Hosp 1, Hefei, Peoples R China
来源
FRONTIERS IN NEUROLOGY | 2021年 / 12卷
基金
中国国家自然科学基金;
关键词
cerebral artery stenosis; plaque stability; neurologic injury; lipoprotein-associated phospholipase A2; acute ischemic stroke; CORONARY-DISEASE; A(2); ATHEROSCLEROSIS; BIOMARKERS; RECURRENCE; PROTEIN; RISK;
D O I
10.3389/fneur.2021.642483
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We aimed to study the clinical utility of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) in acute ischemic stroke (AIS) with cerebral artery stenosis (CAS). We included 200 AIS patients and 90 healthy controls in this study. AIS patients were classified into three subgroups depending on the severity of CAS. They were also classified based on the stability of the carotid plaques. Spearman correlation analysis was performed to determine the correlation relationship between the level of Lp-PLA2 and neurologic injury. Binary logistic regression analysis was performed to determine the independent risk factors for AIS. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic value of Lp-PLA2 for AIS and for the degree of CAS. We found that the serum level of Lp-PLA2 in AIS patients was significantly higher than that in the control group. Lp-PLA2 was further identified as an independent risk factor for AIS (p = 0.001, OR = 1.057). In addition, serum Lp-PLA2 level was the highest in AIS patients with severe CAS or occlusion. Lp-PLA2 level was higher in AIS patients with unstable plaques and in AIS patients with moderate to severe neurological injury. Lp-PLA2 level was positively correlated with National Institutes of Health Stroke Scale (NIHSS) score (r = 0.335, p = 0.001). We found that the optimal cut-off value for Lp-PLA2 level was 123.365 ng/ml, at which the sensitivity and specificity for the diagnosis of ACI were 74.5 and 86.7%, respectively, and the area under ROC curve (AUC) was 0.892. Similarly, the optimal value for Lp-PLA2 level was 136.46 ng/ml, at which the sensitivity and specificity for the diagnosis of the presence of moderate to severe artery stenosis or occlusion were 79.6 and 95.2%, respectively, and the AUC was 0.938. The ROC curve indicated that serum Lp-PLA2 level has an excellent diagnostic value for AIS and severe stenosis. Based on these results we conclude that Lp-PLA2 could be a potential biomarker to complement the current imaging methods in the prediction and diagnosis of AIS. An elevated Lp-PLA2 level is also correlated with carotid plaque instability, severe neurological injury and cerebrovascular stenosis. Future longitudinal studies are needed to determine whether there is a causative relationship between Lp-PLA2 and AIS.
引用
收藏
页数:7
相关论文
共 34 条
  • [2] Serum lipoprotein-associated phospholipase A2 as a promising prognostic biomarker in association with 90-day outcome of acute intracerebral hemorrhage
    Bian, Lin
    Mao, Lian-Gang
    Sun, Yi
    Shen, Feng
    Chen, Jun-Feng
    Liu, Zheng
    Zhou, Wei
    [J]. CLINICA CHIMICA ACTA, 2019, 495 : 429 - 435
  • [3] Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke
    Bonaventura, Aldo
    Liberale, Luca
    Vecchie, Alessandra
    Casula, Matteo
    Carbone, Federico
    Dallegri, Franco
    Montecucco, Fabrizio
    [J]. INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, 2016, 17 (12)
  • [4] Lipoprotein-associated phospholipase A2 as a biomarker for coronary disease and stroke
    Caslake, MJ
    Packard, CJ
    [J]. NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE, 2005, 2 (10): : 529 - 535
  • [5] [中华医学会神经病学分会 Chinese Society of Neurology], 2018, [中华神经科杂志, Chinese Journal of Neurology], V51, P666
  • [6] High-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2, and outcome after ischemic stroke
    Elkind, Mitchell S. V.
    Tai, Wanling
    Coates, Kristen
    Paik, Myunghee C.
    Sacco, Ralph L.
    [J]. ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (19) : 2073 - 2080
  • [7] Association between Cerebral Arterial Stiffness and Large Artery Atherosclerosis in Acute Ischemic Stroke
    Fu, Xian
    Liu, Qi
    Zeng, Xianfan
    Huang, Shiyan
    Huang, Ruxun
    Gao, Qingchun
    [J]. JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2018, 27 (11) : 2993 - 3000
  • [8] Evidence Supporting a Key Role of Lp-PLA2-Generated Lysophosphatidylcholine in Human Atherosclerotic Plaque Inflammation
    Goncalves, Isabel
    Edsfeldt, Andreas
    Ko, Na Young
    Grufman, Helena
    Berg, Katarina
    Bjoerkbacka, Harry
    Nitulescu, Mihaela
    Persson, Ana
    Nilsson, Marie
    Prehn, Cornelia
    Adamski, Jerzy
    Nilsson, Jan
    [J]. ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2012, 32 (06) : 1505 - +
  • [9] Lipoprotein-associated phospholipase A2 and risk of stroke
    Gorelick, Philip B.
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 2008, 101 (12A) : 34F - 40F
  • [10] Lipoprotein-Associated Phospholipase A2 Is Associated with Atherosclerotic Stroke Risk: The Northern Manhattan Study
    Katan, Mira
    Moon, Yeseon P.
    Paik, Myunghee C.
    Wolfert, Robert L.
    Sacco, Ralph L.
    Elkind, Mitchell S. V.
    [J]. PLOS ONE, 2014, 9 (01):