Correlation between serum α-synuclein and sirtuin-1 levels with progressive cerebral infarction

Li Biao; Liang Qian; Ren Yuwei

doi:10.11850/j.issn.1009-122X.2024.09.005

Abstract：Objective To investigate the correlation between serum α-synuclein(α-syn)and Sirtuin-1(SIRT1)levels with the neurological function,infarct volume and prognosis of patients with progressive cerebral infarction.Methods The clinical data of 100 patients with acute cerebral infarction were analyzed retrospectively.They were divided into a progressive group(n=45)and a non-progressive group(n=55)according to the changes in the condition of cerebral infarction.The patients in the progressive group were further subgrouped based on the National Institutes of Health Stroke Scale(NIHSS)score,infarct volume,and prognosis at the time of admission.The differences and correlations of serum α-syn and SIRT1 levels were compared between different degrees of neurological deficit,infarct volume and prognosis,and the diagnostic and prognostic predictive values of α-syn and SIRT1 for progressive cerebral infarction analyzed by using the receiver operating characteristic(ROC)curve.Results The serum α-syn level was higher in the progressive group than in the non-progressive group,and SIRT1 was lower than in the non-progressive group(both P<0.05).The area under curve(AUC)for the combined diagnosis of progressive cerebral infarction by SIRT1 and α-syn was 0.911(0.849～0.973),and the sensitivity and specificity were 84.38%and 82.33%respectively.With the aggravation of neurological deficits,serum α-syn levels in patients with progressive cerebral infarction showed a trend of gradual increase,while SIRT1 kept decreasing(P<0.05).With the increase of infarct volume,the serum α-syn level of patients with progressive cerebral infarction constantly increased,while SIRT1 showed a decreasing trend(P<0.05).Compared with the good prognosis group,the serum SIRT1 level was lower and the α-syn level was higher in the poor prognosis group(P<0.05).Serum α-syn level was positively correlated with the degree of neurological deficit,the volume of cerebral infarction and poor prognosis in patients with progressive cerebral infarction(r=0.713,0.821,0.739,P<0.05).Serum SIRT1 level was negatively correlated with the degree of neurological deficit,infarct volume and poor prognosis in patients with progressive cerebral infarction(r=-0.694,-0.773,-0.633,P<0.05).The combined detection of SIRT1 and α-syn was effective in predicting poor prognosis in patients with progressive cerebral infarction with AUC of 0.887(0.812-0.963),with a sensitivity of 87.64%and a specificity of 77.63%.Conclusion Combined detection of α-syn and SIRT1 levels is of high value in predicting the progression of cerebral infarction and poor prognosis,and may provide clinical guidance.