Effect of Serum GFAP and PRL Levels on Relapse in Patients with Optic Neuromyelitis Spectrum Disease

CHEN Xiaojing; SHANG Fangfang; LIU Hongzhao

doi:10.3969/j.issn.1004-437X.2026.04.016

Abstract：Objective To investigate the effects of serum glial fibrillary acid protein(GFAP)and prolactin(PRL)on relapse in patients with optic neuromyelitis spectrum disease(NMOSD).Methods A total of 139 patients with NMOSD admitted to Nanyang Central Hospital from December 2019 to May 2021 were selected for 1 year follow-up,through which they were divided into a relapse group(76 cases)and a non-recurrence group(63 cases)according to the recurrence.The serum GFAP and PRL levels and clinical data of the two groups were compared.The influencing factors of NMOSD recurrence were analyzed by logistic regression,and the predictive value of serum GFAP and PRL levels for recurrence of NMOSD patients was analyzed by receiver operating characteristic(ROC)curve.Results Gender,age,extended dysfunction status scale(EDSS)score,aquaporin 4(AQP-4)antibody,total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were compared between the two groups,and there were statistically significant differences(P＜0.05).The levels of serum GFAP and PRL in relapsed group were higher than those in non-relapsed group(P＜0.05).Logistic regression analysis showed that positive AQP-4 antibody,TC,LDL-C,GFAP and PRL were risk factors for recurrence of NMOSD(P＜0.05).ROC analysis showed that the area under the curve(AUC)(95％CI)of serum GFAP and PRL to predict the recurrence of NMOSD patients were 0.816(0.742-0.877)and 0.804(0.728-0.866),the corresponding sensitivity was 64.47％,82.89％,and the specificity was 90.48％,63.49％.The combined prediction of AUC(95％CI)for recurrence in NMOSD patients was 0.914(0.854-0.955),sensitivity was 78.95％,and specificity was 95.24％.Conclusion The levels of serum GFAP and PRL in patients with NMOSD recurrence are higher.The levels of serum GFAP and PRL are risk factors for recurrence of NMOSD,which can be used as reference indicators to predict recurrence of NMOSD patients.Monitoring the levels of serum GFAP and PRL may be helpful to detect recurrence as early as possible.