Relationship between serum LncRNA UCA1 and NPASDP4 levels and neurological deficits in patients with acute cer-ebral infarction and their predictive value for prognosis

Zhai Yu; Wang Fang; Shen Hongxian; Li Xiaoxi; Gao Fengjuan; Ni Jun

doi:10.3969/j.issn.1671-6450.2024.09.002

Abstract：Objective To investigate the relationship between serum levels of long non coding ribonucleic acid urothelial carcinoma antigen 1(LncRNA UCA1)and neuronal PAS domain protein 4(NPADP4)and neurological dysfunction in patients with acute cerebral infarction(ACI),and their predictive value for prognosis.Methods A total of 163 patients with acute cerebral infarction(ACI)admitted to the Emergency Department of Nanjing University Medical School Affiliated Drum Tower Hospital from January 2021 to June 2023(ACI group)[32 cases in mild,73 cases in moderate,and 58 cases in severe defect subgroups,respectively]and 65 healthy individuals who underwent physical examinations during the same pe-riod(control group)were selected.ACI patients were divided into poor and good prognosis subgroups based on their 90-day prognosis,with 52 cases and 111 cases in each subgroup.Real time fluorescence quantitative polymerase chain reaction and enzyme linked immunosorbent assay were used to detect the levels of serum LncRNA UCA1 and NPADP4.Spearman correlation analysis was conducted to investigate the correlation between serum LncRNA UCA1,NPADP4 levels and the National Institutes of Health Stroke Scale(NIHSS)scores of ACI patients.Multivariate logistic regression analysis was used to identify the factors contributing to poor prognosis in ACI patients,and ROC curve analysis was performed to evaluate the predictive value of serum LncRNA UCA1 and NPADP4 for poor prognosis in ACI patients.Results Compared with the control group,the levels of serum LncRNA UCA1 and NPADP4 increased in the ACI group(t/P=20.114/＜0.001,15.711/＜0.001).The levels of serum LncRNA UCA1 and NPADP4 were higher in the severe defect subgroup than in the moderate defect subgroup than in the mild defect subgroup(F/P=187.914/＜0.001,195.031/＜0.001).The levels of serum LncRNA UCA1 and NPADP4 in ACI patients were positively correlated with NIHSS scores(r/P=0.759/＜0.001,0.773/＜0.001).After a 90 day follow up,the incidence of poor prognosis in 163 patients with ACI was 31.90％ (52/163).Compared with the good prognosis subgroup,the levels of serum LncRNA UCA1 and NPADP4 were elevated in the poor prognosis subgroup(t/P=6.963/＜0.001,6.515/＜0.001).The independent risk factors for poor prognosis in ACI patients were age,increased NIHSS score,elevated LncRNA UCA1 and NPADP4[OR(95％ CI)=1.107(1.043-1.176),1.098(1.049-1.150),3.479(1.941-6.235),1.959(1.398-2.745)].The AUC predicted by serum LncRNA UCA1,NPADP4,and their combination were 0.777,0.789,and 0.870,respectively.The AUC predicted by their combination was greater than that predicted by serum LncRNA UCA1 and NPADP4 alone(Z/P=3312/＜0.05,2.721/＜0.05).Conclusion Elevated levels of serum LncRNA UCA1 and NPADP4 are closely associated with worsening neurological deficits and poor prognosis in ACI patients.The combination of serum Ln-cRNA UCA1 and NPADP4 levels has high value in predicting poor prognosis in ACI patients.