Association of serum homer 1 and MFG-E8 levels with delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage

Li Zhijian; Li Yuan; Qian Zhengtong; Zhang Zhihao; Guan Dongfeng

doi:10.3969/j.issn.1671-6450.2025.10.008

Abstract：Objective To investigate the relationship between serum levels of Homer1 and milk fat globule-epidermal growth factor 8(MFG-E8)and delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH).Methods A total of 109 patients with aSAH admitted to the Department of Neurosurgery,Linfen People's Hospital from June 2021 to June 2024 were enrolled as the aSAH group.These patients were further divided into DCI subgroup and non-DCI subgroup based on DCI occurrence.Additionally,109 healthy individuals undergoing physical examination during the same period were selected as the healthy control group.Serum Homer1 and MFG-E8 levels were measured using enzyme-linked immunosorbent assay(ELISA).Spearman's correlation analysis was used to analyze the correlations between serum Homer1/MFG-E8 levels and modified Fisher grade and World Federation of Neurosurgical Societies(WFNS)grade in aSAH patients with DCI.Multivariate logistic regression analysis was performed to identify factors influencing DCI occurrence in aSAH patients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive efficacy of serum Homer1 and MFG-E8 levels for DCI.Results Serum Homer1 and MFG-E8 levels in the aSAH group were significantly higher than those in the healthy control group(t/P=22.146/＜0.001,26.088/＜0.001).Compared with the non-DCI subgroup,the DCI subgroup had older age,higher proportions of hypertension,aneurysm diameter＞15 mm,modified Fisher grade Ⅲ-Ⅳ,and WFNS grade Ⅲ-Ⅳ,as well as higher serum Homer1 and MFG-E8 levels(t/x2/P=2.214/0.029,4.974/0.026,8.928/0.012,12.118/＜0.001,6.016/0.014,16.231/＜0.001,142.580/＜0.001).In aSAH patients with DCI,serum Homer1 and MFG-E8 levels were positively correlated with modified Fisher grade and WFNS grade(Homer1:rs/P=0.306/0.002,0.441/＜0.001;MFG-E8:rs/P=0.480/＜0.001,0.386/＜0.001).Multivariate logistic regression analysis showed that modified Fisher grade Ⅲ-Ⅳ,high Ho-mer1 level,and high MFG-E8 level were independent risk factors for DCI in aSAH patients[OR(95％CI)=2.060(1.165-3.645),1.540(1.146-2.071),1.663(1.162-2.381)].The areas under the curve(AUC)of serum Homer1,MFG-E8,and their combination for predicting DCI were 0.796,0.759,and 0.906,respectively,with the combined prediction being superior to ei-ther biomarker alone(Z/P=2.265/0.024,3.119/0.002).Conclusion Elevated serum Homer1 and MFG-E8 levels in aSAH pa-tients are associated with higher WFNS grade,higher modified Fisher grade,and DCI occurrence.The combination of Homer1 and MFG-E8 demonstrates effective predictive value for DCI risk.