Relationship between serum biomarker levels and early neurological deterioration in patients with branch atheromatous disease
Zhu Lili
Fu Shengqi
Hu Shengjie
Yu Meng
Zhang Hongtao
Song Liang
Liu Haitao
Abstract：Objective To investigate the relationship of serum high-sensitivity C-reactive protein(hs-CRP),small and dense low-density lipoprotein cholesterol(sdLDL-C),lipoprotein phospho-lipase A2(Lp-PLA2),cystatin C(Cys C),and uric acid/creatinine(UA/Cr)ratio with early neu-rological deterioration(END)in patients with branch atheromatous disease(BAD).Methods A total of 235 BAD patients admitted to our department from July 2020 to January 2023 were pro-spectively enrolled in this study.END was defined when the score of motor item in the second NIHSS within 7 d of admission was increased by ≥1 point or the total score was increased by 2 points,and then the patients were divided into an END group(56 cases)and a non-END group(179 cases).The serum levels of hs-CRP,sdLDL-C,Lp-PLA2 and Cys C and UA/Cr ratio were recorded at the time of admission.Multivariate logistic regression analysis was used to explore the risk factors for END in BAD patients,and ROC curve analysis was employed to identify the accu-racy of above 5 indicators in predicting END.Results The END group had significantly higher se-rum levels of sdLDL-C,hs-CRP,Lp-PLA2,Cr and Cys C,increased NIHSS score at discharge,and elevated mRS score in 3 month after onset,but lower male ratio,UA level and UA/Cr ratio when compared with the non-END group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that hs-CRP(OR=1.160,95％CI:1.044-1.290,P=0.006),sdLDL-C(OR=4.756,95％CI:1.994-11.344,P=0.000),Cys C(OR=4.555,95％CI:2.191-9.470,P=0.000)and Lp-PLA2(OR=1.025,95％CI:1.013-1.037,P=0.000)were independent risk factors for END,while,UA/Cr ratio(OR=0.424,95％CI:0.280-0.642,P=0.000)was a protective factor for END in the BAD patients.ROC curve analysis indicated that the AUC value of combined serum levels of hs-CRP,sdLDL-C,Lp-PLA2 and Cys C and UA/Cr ratio together for END was 0.853(95％CI:0.791-0.916),with a sensitivity and specificity of 75.0％and 84.4％,repectively.Con-clusion Serum levels of hs-CRP,sdLDL-C,Lp-PLA2 and Cys C and UA/Cr ratio can be used as independent predictors for END in BAD patients,and their combined detection is helpful for the assessment of patients'condition.
Keywords：C-reactive proteinuric acidcreatinineneurologic manifestationsbranch atheroma-tous diseasesmall and dense low-density lipoprotein cholesterol
Publication Date：2024-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 413-417 )