Relationship of the levels of differentiation antagonizing non-protein coding RNA and micro RNA-214-5p to the size of acute cerebral infarct foci and prognosis

ZHAO Liping; ZHANG Deyu; TONG Dandan; ZHANG Wenjing; SHEN Jianguo; WANG Jinghua

doi:10.11850/j.issn.1009-122X.2025.11.005

Abstract：Objective To observe the changes in the levels of differentiation antagonizes non-protein coding RNA(DANCR)and micro RNA-214-5p(miR-214-5p)in patients with acute cerebral infarct(ACI)and to explore the correlation between their expression and both the size of cerebral infarct foci and clinical prognosis.Methods Clinical data of 123 ACI patients were analyzed retrospectively.Based on the size of the cerebral infarction,the patients were divided into three groups:small infarct group(<5 cm³,39 cases),medium infarct group(5-10 cm³,61 cases),and large infarct group(>10 cm³,23 cases).The prognosis was evaluated using the National Institute of Health Stroke Scale(NIHSS)score,with ACI patients having an NIHSS score<6 classified into the good prognosis group(84 cases)and those with an NIHSS score≥6 into the poor prognosis group(39 cases).Additionally,117 healthy individuals who underwent physical examinations during the same period were selected as the control group.Real-time quantitative PCR(RT-qPCR)was used to analyze DANCR and miR-214-5p.Logistic regression was applied to explore the factors associated with poor prognosis in ACI patients.The correlation between DANCR and miR-214-5p was assessed using Pearson's test.The receiver operating characteristic(ROC)curve were constructed to investigate the expression and clinical significance of DANCR and miR-214-5p in ACI patients.Results Compared with the control group,the expression of DANCR in ACI patients was significantly increased(P<0.001),while miR-214-5p was significantly downregulated(P<0.001).There was a significant negative correlation between DANCR and miR-214-5p in ACI patients(r=-0.486,P<0.001).Compared with the small infarct group,the serum levels of DANCR were significantly higher and miR-214-5p levels were significantly lower in the medium and large infarct groups(all P<0.05);compared with the medium infarct group,the serum levels of DANCR were significantly higher and miR-214-5p levels were significantly lower in the large infarct group(all P<0.05).Compared with the good prognosis group,the poor prognosis group had higher serum DANCR levels,a longer time from onset to admission,and significantly lower miR-214-5p levels(all P<0.001).DANCR was a risk factor for poor prognosis in ACI patients(OR=2.013,95%CI:1.079-3.754,P=0.028),while miR-214-5p was a protective factor(OR=0.806,95%CI:0.657-0.988,P=0.038).The areas under the ROC curves(AUC)for DANCR,miR-214-5p,and their combined diagnosis of poor prognosis in ACI patients were 0.727,0.739,and 0.857,respectively.The combined diagnostic performance was higher than that of individual tests(Z=2.070,P=0.038;Z=2.097,P=0.036).Conclusions High expression of serum DANCR and low expression of miR-214-5p in ACI patients may be significantly associated with the size of cerebral infarct foci and prognosis.The combination of the two has certain value in diagnosing poor prognosis in the patients.