Ran Xiao, Wang Dao Wen, Yu Zhen, Wu Rongxue, Zhang Qin
Department of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China.
The Institute of Hypertension and Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China.
J Inflamm Res. 2022 Jan 6;15:117-126. doi: 10.2147/JIR.S343972. eCollection 2022.
Tissue kallikrein (TK) exerts protective effects on cardiac cerebrovascular diseases (CCVDs). Changes in TK level in plasma are associated with ischemic stroke and coronary artery disease (CAD); however, a causal correlation could not be established. Therefore, we investigated the association between TK levels and CCVDs in a community-based cross-sectional study in China.
A total of 6043 subjects (4242 men and 1801 women) were enrolled in this community-based cross-sectional study. Then, TK levels were measured using an enzyme-linked immunosorbent assay kit. Multivariate linear regression model and logistic regression were used to assess the correlations between TK levels and CCVDs. Subsequently, the receiver operating characteristic (ROC) curve was drawn to assess the value of TK level in evaluating the risk of ischemic stroke. Finally, the influence of various medications was evaluated on TK levels.
The TK level was significantly lower in subjects with ischemic stroke (P < 0.001) and hypertension (P < 0.001) and negatively associated with ischemic stroke (P < 0.001) but not associated with hypertension, coronary heart disease, and diabetes compared to the traditional risk factors. The diagnostic accuracy for ischemic stroke, as quantified by the area under the curve, was 0.892 (95% CI, 0.884-0.900) for TK level, deeming it as a promising assessment tool. Moreover, no appreciable influence of various drugs therapy was found in TK levels (P = 0.222) except for those taking antilipemic agents.
TK is a strong and independent endogenous protective factor against ischemic stroke in the Chinese population and could be a promising biomarker for the risk of ischemic stroke.
组织激肽释放酶（TK）对心脑血管疾病（CCVDs）具有保护作用。血浆中TK水平的变化与缺血性中风和冠状动脉疾病（CAD）相关；然而，无法建立因果关系。因此，我们在中国一项基于社区的横断面研究中调查了TK水平与CCVDs之间的关联。
共有6043名受试者（4242名男性和1801名女性）参与了这项基于社区的横断面研究。然后，使用酶联免疫吸附测定试剂盒测量TK水平。采用多元线性回归模型和逻辑回归评估TK水平与CCVDs之间的相关性。随后，绘制受试者工作特征（ROC）曲线以评估TK水平在评估缺血性中风风险中的价值。最后，评估了各种药物对TK水平的影响。
与传统风险因素相比，缺血性中风患者（P < 0.001）和高血压患者（P < 0.001）的TK水平显著降低，且与缺血性中风呈负相关（P < 0.001），但与高血压、冠心病和糖尿病无关。以曲线下面积量化的缺血性中风诊断准确性，TK水平为0.892（95%CI，0.884 - 0.900），认为它是一种有前景的评估工具。此外，除服用降脂药物的患者外，未发现各种药物治疗对TK水平有明显影响（P = 0.222）。
TK是中国人群中对抗缺血性中风的强大且独立的内源性保护因子，可能是缺血性中风风险的一种有前景的生物标志物。
