Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Neurology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Neurol Sci. 2019 Dec;40(12):2565-2572. doi: 10.1007/s10072-019-04006-y. Epub 2019 Jul 20.
Different models that include clinical variables and blood markers have been investigated to predict acute ischemic stroke treatment course and recovery.
The aim of the study was to investigate associations between lipid levels, lifestyle factors, hemostatic (F5, F2, SERPINE1, F13A1, and FGB), and atherogenic (APOA5 and ACE) gene variants and acute ischemic stroke (AIS) severity.
This study included 250 patients with AIS in which F5, F2, SERPINE1, F13A1, FGB, APOA5, and ACE genotypes were determined. Total cholesterol (TC), high-density cholesterol, low-density cholesterol, and triglycerides concentrations were measured within 24 h of the AIS onset. Examination of the neurological deficit was done using National Institutes of Health Stroke Scale/Score (NIHSS).
APOA5 genotype [TC + CC] was more frequent (P = 0.026) in patients with the NIHSS score ≥ 21. Univariate regression analysis has shown that triglycerides (OR 0.55, 95% CI 0.34-0.91; P = 0.019), obesity (0.28, 95% CI 0.10-0.73; P = 0.010), age (OR 1.08, 95% CI 1.04-1.13; P < 0.001), and APOA5 genotype (TC + CC) (OR 2.40, 95% CI 1.10-5.25; P = 0.034) are significantly associated with a severe stroke. When all variables were included in model age (OR 1.06, 95% CI 1.01-1.11; P = 0.018), obesity (OR 0.25, 95% CI 0.08-0.77; P = 0.016) and APOA5 genotype (TC + CC) (OR 3.26, 95% CI 1.29-8.23; P = 0.012) remained significant for the risk of severe AIS.
APOA5 genotype (TC + CC), age, and obesity could be used as prognostic risk factors for a very severe stroke (NIHSS ≥ 21).
已有研究提出了多种包含临床变量和血液标志物的模型，用于预测急性缺血性脑卒中的治疗过程和恢复情况。
本研究旨在探讨血脂水平、生活方式因素、止血（F5、F2、SERPINE1、F13A1 和 FGB）和动脉粥样硬化（APOA5 和 ACE）基因变异与急性缺血性脑卒中（AIS）严重程度之间的关系。
本研究纳入了 250 名 AIS 患者，对其 F5、F2、SERPINE1、F13A1、FGB、APOA5 和 ACE 基因型进行了检测。在 AIS 发病后 24 小时内测量了总胆固醇（TC）、高密度胆固醇、低密度胆固醇和甘油三酯浓度。使用国立卫生研究院卒中量表/评分（NIHSS）评估神经功能缺损情况。
APOA5 基因型 [TC+CC] 在 NIHSS 评分≥21 的患者中更为常见（P=0.026）。单因素回归分析显示，甘油三酯（OR 0.55，95%CI 0.34-0.91；P=0.019）、肥胖（OR 0.28，95%CI 0.10-0.73；P=0.010）、年龄（OR 1.08，95%CI 1.04-1.13；P<0.001）和 APOA5 基因型（TC+CC）（OR 2.40，95%CI 1.10-5.25；P=0.034）与严重脑卒中显著相关。当将所有变量纳入模型时，年龄（OR 1.06，95%CI 1.01-1.11；P=0.018）、肥胖（OR 0.25，95%CI 0.08-0.77；P=0.016）和 APOA5 基因型（TC+CC）（OR 3.26，95%CI 1.29-8.23；P=0.012）仍然是严重 AIS 的显著风险因素。
APOA5 基因型（TC+CC）、年龄和肥胖可作为预测非常严重脑卒中（NIHSS≥21）的预后危险因素。
