Ageing Clinical and Experimental Research, Institute of Applied Health Sciences, Aberdeen, UK.
Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Stoke-on-Trent, UK.
Eur J Neurol. 2021 Nov;28(11):3650-3655. doi: 10.1111/ene.15004. Epub 2021 Jul 30.
Previous literature has demonstrated an association between high serum levels of type II secretory phospholipase A2 (sPLA2) concentration and an increased risk of coronary artery disease. However, such association has not been established in terms of ischaemic stroke risk. The aim was to evaluate the association between both sPLA2 concentration and activity as continuous variables with risk of future ischaemic stroke.
A nested case-control study was conducted using data from the European Prospective Investigation into Cancer-Norfolk study. Cases (n = 145) in the current study were participants who developed ischaemic stroke during follow-up, with controls (n = 290) matched in a 2:1 ratio based on age and sex. Statistical analyses were performed using SPSS (version 25.0) software. Logistic regression was used to determine odds ratios (OR) and corresponding 95% confidence intervals (95% CIs) for ischaemic stroke.
After adjusting for a wide array of cardiovascular confounders, sPLA2 activity was found to be associated with an increased risk of ischaemic stroke using both multiple imputations with chained equations and complete case analysis: OR 1.20 (95% CI 1.01-1.43) and OR 1.23 (95% CI 1.01-1.49), respectively. However, sPLA2 concentration was not found to be associated with increased risk of ischaemic stroke.
The activity of sPLA2, but not sPLA2 concentration, is associated with an increased risk of future ischaemic stroke. This finding may be significant in risk group stratification, allowing targeted prophylactic treatment, or the development of novel therapeutic agents.
既往文献表明,Ⅱ型分泌型磷脂酶 A2(sPLA2)血清浓度与冠状动脉疾病风险增加相关。然而,其与缺血性卒中风险的相关性尚未确定。本研究旨在评估 sPLA2 浓度和活性作为连续变量与未来缺血性卒中风险之间的相关性。
采用欧洲前瞻性癌症-诺福克研究的数据进行巢式病例对照研究。本研究中的病例(n=145)为随访期间发生缺血性卒中的参与者,对照组(n=290)按年龄和性别以 2:1 的比例匹配。使用 SPSS(版本 25.0)软件进行统计分析。使用 logistic 回归确定缺血性卒中的比值比(OR)和相应的 95%置信区间(95%CI)。
在调整了广泛的心血管混杂因素后,使用多重插补与链式方程和完全病例分析,sPLA2 活性与缺血性卒中风险增加相关:OR 1.20(95%CI 1.01-1.43)和 OR 1.23(95%CI 1.01-1.49)。然而,sPLA2 浓度与缺血性卒中风险增加无关。
sPLA2 的活性,而不是浓度,与未来缺血性卒中风险增加相关。这一发现可能在风险分层中具有重要意义,允许针对性的预防性治疗或新型治疗药物的开发。