Evaluation value of serum Dickkopf-related protein 1 combined with apnea-hypopnea index for acute ischemic stroke risk in patients with obstructive sleep apnea-hypopnea syndrome

Zhang Pengfei; Gao Bin; Sun Ya

doi:10.3760/j.issn.1673-4777.2026.03.010

Abstract：Objective To explore the evaluation value of serum Dickkopf-related protein 1(DKK-1)combined with apnea-hypopnea index(AHI)for acute ischemic stroke(AIS)risk in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 223 OSAHS patients treated in Yan'an University Affiliated Hospital from January 2021 to December 2024 were enrolled.According to the occurrence of AIS during follow-up,the patients were divided into the AIS group and non-AIS group.They were further divided into the high-expression group and low-expression group according to the serum DKK-1 level.Enzyme-linked immunosorbent assay was used to detect the serum DKK-1 level of all OSAHS patients.Meanwhile,the clinical data and AHI of all OSAHS patients were collected for comparison,and the evaluation value of serum DKK-1 and AHI for AIS risk in OSAHS patients was analyzed.Results All 223 patients completed the follow-up,including 182 cases in the non-AIS group and 41 cases in the AIS group.The age,proportion of atrial fibrillation,serum DKK-1 level and AHI in the AIS group were significantly higher than those in the non-AIS group(all P＜0.05).Multivariate Logistic regression model analysis showed that atrial fibrillation,high serum DKK-1 level and high AHI were risk factors for AIS in OSAHS patients(odds ratio=2.812,2.654,2.370,all P＜0.05).Receiver operating charac-teristic curve analysis showed that serum DKK-1 and AHI had good evaluation value for AIS risk in OSAHS patients,with the areas under the curve(AUC)of 0.766(95％confidence interval:0.662-0.869)and 0.763(95％confidence interval:0.666-0.860),respectively.The AUC of their combination was increased to 0.896(95％confidence interval:0.830-0.963),which was superior to that of each single index(both P＜0.05).The incidence of AIS and AHI in the DKK-1 high-expression group were significantly higher than those in the low-expression group[25.6％(21/82)vs 14.2％(20/141),(27±5)times/h vs(21±5)times/h](both P＜0.05).Conclusion High serum DKK-1 level and high AHI are risk factors for AIS in OSAHS patients,and the combination of serum DKK-1 and AHI has good evaluation value for AIS risk in OSAHS patients.