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血清肝细胞生长因子与缺血性脑卒中预后的关系:血脂状态的作用。

Association between serum hepatocyte growth factor and prognosis of ischemic stroke: The role of blood lipid status.

作者信息

Zhu Zhengbao, Wang Aili, Guo Daoxia, Bu Xiaoqing, Xu Tan, Zhong Chongke, Peng Yanbo, Xu Tian, Peng Hao, Chen Jing, Ju Zhong, Geng Deqin, He Jiang, Zhang Yonghong

机构信息

Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.

出版信息

Nutr Metab Cardiovasc Dis. 2020 Mar 9;30(3):492-499. doi: 10.1016/j.numecd.2019.11.005. Epub 2019 Nov 14.

Abstract

BACKGROUND AND AIMS

High serum hepatocyte growth factor (HGF) levels increase the risk of ischemic stroke and are probably associated with outcomes after ischemic stroke. However, it remains unclear whether the association between HGF and ischemic stroke prognosis is modified by blood lipid status.

METHODS AND RESULTS

Data were derived from the CATIS (China Antihypertensive Trial in Acute Ischemic Stroke), and we measured baseline serum HGF levels in 3027 ischemic stroke patients. The primary outcome was a combination of death and major disability (modified Rankin Scale score≥3) at 2 years after ischemic stroke. Blood lipid status could modify association between HGF and ischemic stroke prognosis (P = 0.002). After multivariate adjustment, the odds ratios of primary outcome associated with the highest tertile of HGF were 2.13 (95% CI, 1.45-3.14; P<0.001) for patients with dyslipidemia and 0.81 (95% CI, 0.54-1.22; P = 0.310) for those with normal lipids. Adding HGF to conventional risk factors improved risk prediction for primary outcome in patients with dyslipidemia (net reclassification improvement: 24.28%, P < 0.001; integrated discrimination index: 0.43%, P = 0.022) but not in those with normal lipids. Secondary analyses further revealed that HDL-C was the main lipid component to modify the prognostic significance of serum HGF among ischemic stroke patients.

CONCLUSIONS

There was a modified effect of blood lipid status on the association between serum HGF and ischemic stroke prognosis. Elevated serum HGF was associated with outcomes in ischemic stroke patients with dyslipidemia, especially low HDL-C. Further studies are warranted to replicate our findings and clarify the potential biological mechanisms.

摘要

背景与目的

血清肝细胞生长因子(HGF)水平升高会增加缺血性卒中的风险,且可能与缺血性卒中后的预后相关。然而,HGF与缺血性卒中预后之间的关联是否会因血脂状况而改变仍不清楚。

方法与结果

数据来源于CATIS(中国急性缺血性卒中降压试验),我们测定了3027例缺血性卒中患者的基线血清HGF水平。主要结局为缺血性卒中后2年的死亡和严重残疾(改良Rankin量表评分≥3)。血脂状况可改变HGF与缺血性卒中预后之间的关联(P = 0.002)。多因素调整后,血脂异常患者中与HGF最高三分位数相关的主要结局的比值比为2.13(95%CI,1.45 - 3.14;P<0.001),血脂正常患者为0.81(95%CI,0.54 - 1.22;P = 0.310)。将HGF添加到传统危险因素中可改善血脂异常患者主要结局的风险预测(净重新分类改善:24.28%,P < 0.001;综合判别指数:0.43%,P = 0.022),但对血脂正常患者无效。二次分析进一步显示,高密度脂蛋白胆固醇(HDL-C)是改变缺血性卒中患者血清HGF预后意义的主要血脂成分。

结论

血脂状况对血清HGF与缺血性卒中预后之间的关联有修饰作用。血清HGF升高与血脂异常的缺血性卒中患者的预后相关,尤其是HDL-C水平低的患者。有必要进行进一步研究以重复我们的发现并阐明潜在的生物学机制。

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