The predictive value of serum CHI3L1 and Sestrin2 for recurrent ischemic stroke in patients with symptomatic carotid artery stenosis

doi:10.11958/20253598

Abstract

Abstract:

Objective To explore the predictive value of serum chitinase-3-like protein 1 (CHI3L1) and Sestrin2 for recurrent ischemic stroke (IS) in patients with symptomatic carotid artery stenosis (SCAS). Methods A total of 82 SCAS patients were prospectively enrolled and divided into the recurrence group (27 cases) and the non-recurrence group (55 cases) based on whether they experienced recurrent IS. The ultrasound diagnostic instrument was used to conduct the carotid artery ultrasound examination. Serum CHI3L1 and Sestrin2 levels were detected by ELISA method. General information of patients were collected. Pearson method was used to analyze the correlations between serum CHI3L1, Sestrin2 and ultrasound indicators. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum CHI3L1 and Sestrin2 for the recurrence of IS in patients with SCAS. Results The proportion of hyperlipidemia, severe stenosis, levels of CHI3L1 and Sestrin2, arterial stenosis rate, area under the time-intensity curve (AUCTC) and peak intensity were higher in the recurrent group compared to the non-recurrent group (P<0.05). Serum CHI3L1 and Sestrin2 were positively correlated with carotid artery stenosis rate, AUCTC and peak intensity (r=0.496, 0.547, 0.529, 0.489, 0.535, 0.511, P<0.05). The risks of recurrent IS in SCAS patients with high CHI3L1 and Sestrin2 levels were 3.618-fold (95%CI: 1.518-8.620) and 2.591-fold (95%CI: 1.232-5.451), which was higher compared to those with corresponding low levels. The area under the curve (AUC) for serum CHI3L1 and Sestrin2 individually and combined in predicting recurrent IS was 0.811 (95%CI: 0.700-0.922), 0.737 (95%CI: 0.622-0.852) and 0.879 (95%CI: 0.790-0.969), respectively, with the combined prediction being superior to each individual prediction (all P<0.05). Conclusion In SCAS, the serum levels of CHI3L1 and Sestrin2 in patients with recurrent IS are both abnormally elevated, and combined detection can improve the predictive effectiveness for recurrent IS in SCAS patients.

Key words: ischemic stroke, carotid stenosis, recurrence, chitinase-3-like protein 1, sestrins

CLC Number:

R743.3

Figures/Tables 7

References 20

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指标	n		年龄/岁		性别				BMI/（kg/m2）
指标	n		年龄/岁				男	女	BMI/（kg/m2）
未再发组	55		70.85±6.29		39（70.91）			16（29.09）	22.76±2.93
再发组	27		72.33±6.42		21（77.78）			6（22.22）	22.92±2.79
t或χ²			0.995		0.435				0.236
指标	吸烟史		饮酒史		高血压				冠心病史
未再发组	16（29.09）		15（27.27）		19（34.55）				10（18.18）
再发组	12（44.44）		10（37.04）		15（55.56）				8（29.63）
t或χ2	1.898		0.815		3.294				1.385
指标		高脂血症		糖尿病		重度狭窄
未再发组		12（21.82）		14（25.45）		13（23.64）
再发组		13（48.15）		10（37.04）		17（62.96）
t或χ²		5.924^＊		1.174		12.072^＊＊

指标	n		年龄/岁		性别				BMI/（kg/m2）
指标	n		年龄/岁				男	女	BMI/（kg/m2）
未再发组	55		70.85±6.29		39（70.91）			16（29.09）	22.76±2.93
再发组	27		72.33±6.42		21（77.78）			6（22.22）	22.92±2.79
t或χ²			0.995		0.435				0.236
指标	吸烟史		饮酒史		高血压				冠心病史
未再发组	16（29.09）		15（27.27）		19（34.55）				10（18.18）
再发组	12（44.44）		10（37.04）		15（55.56）				8（29.63）
t或χ2	1.898		0.815		3.294				1.385
指标		高脂血症		糖尿病		重度狭窄
未再发组		12（21.82）		14（25.45）		13（23.64）
再发组		13（48.15）		10（37.04）		17（62.96）
t或χ²		5.924^＊		1.174		12.072^＊＊

组别	n	CHI3L1	Sestrin2
未再发组	55	68.59±9.62	10.09±2.86
再发组	27	87.61±12.47	15.13±3.22
t		7.615^**	7.196^**

组别	n	CHI3L1	Sestrin2
未再发组	55	68.59±9.62	10.09±2.86
再发组	27	87.61±12.47	15.13±3.22
t		7.615^**	7.196^**

组别	n	颈动脉狭窄/%	AUCTC/（dB/s）	基线强度/dB	峰值强度/dB
未再发组	55	67.35±9.03	427.08±84.75	2.51±0.48	12.15±3.69
再发组	27	76.48±10.19	701.34±89.62	2.58±0.51	21.78±5.86
t		4.125^**	13.514^**	0.611	9.085^**