Serum SIRT3 and Apo-J levels in patients with spontaneous intracerebral hemorrhage and the relationship with early neurological deterioration

Wang Jingyun; Zheng Wei; Wang Yanan; Li Bing

doi:10.3969/j.issn.1671-6450.2025.04.011

Abstract：Objective To investigate the levels of serum sirtuin 3(SIRT3)and apolipoprotein J(Apo-J)in patients with spontaneous intracerebral hemorrhage(sICH)and their relationship with early neurological deterioration(END).Met-hods A retrospective study was conducted on 303 sICH patients(ICH group)admitted to the Neurology Department of Jiaozhou Central Hospital,Qingdao,from January 2020 to August 2024,and 155 healthy volunteers(control group)from the same hospital.Based on neurological deficit severity,sICH patients were classified into mild deficit subgroup(102 cases,NIHSS score ≤4),moderate deficit subgroup(121 cases,NIHSS score 5-20),and severe deficit subgroup(80 cases,NIHSS score＞20).Patients were further divided into END subgroup(60 cases)and non-END subgroup(243 cases)based on the occurrence of END.Serum SIRT3 and Apo-J levels were measured by enzyme-linked immunosorbent assay(ELISA).Spearman correlation analysis was performed to examine the relationship between serum SIRT3 and Apo-J levels and NIHSS scores in sICH patients.Multivariate unconditional logistic regression was used to analyze the association of serum SIRT3 and Apo-J levels with END in sICH patients,and the predictive efficacy of serum SIRT3 and Apo-J levels for END was as-sessed using ROC curves.Results Compared to the control group,serum SIRT3 levels were decreased and Apo-J levels were elevated in the sICH group(t/P=26.232/＜0.001,30.021/＜0.001).Serum SIRT3 levels progressively decreased,and Apo-J levels progressively increased across the mild,moderate,and severe deficit subgroups(F/P=805.445/＜0.001,550374/＜0.001).NIHSS scores in sICH patients were negatively correlated with serum SIRT3 levels and positively correlated with Apo-J levels(rs/P=-0.809/＜0.001,0.792/＜0.001).The incidence of END among the 303 sICH patients was 19.80％(60/303).Compared to the non-END subgroup,the END subgroup showed lower serum SIRT3 levels and higher Apo-J levels(t/P=8.539/＜0.001,7.972/＜0.001).Larger hematoma volume,higher baseline NIHSS scores,and elevated Apo-J were inde-pendent risk factors for END,while higher baseline GCS scores and elevated SIRT3 were independent protective factors[OR(95％CI)=1.143(1.072-1218),1.091(1.036-1.148),1.079(1.046-1.114),0.726(0.620-0.850),0.469(0.339-0.650)].The AUC for predicting END using serum SIRT3,Apo-J,and their combination was 0.790,0.786,and 0.891,respectively.The combined AUC was significantly higher than that of SIRT3 or Apo-J alone(Z/P=4.079/＜0.001,4.086/＜0.001).Conclusion In sICH patients,serum SIRT3 levels decrease,and Apo-J levels increase,which are associated with more severe neurological defi-cits and the occurrence of END.The combination of serum SIRT3 and Apo-J levels demonstrates high predictive efficacy for END in sICH patients.