Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2022 Dec;28(12):2001-2010. doi: 10.1111/cns.13932. Epub 2022 Jul 31.
The prognostic value of soluble lectin-like oxidized low-density lipoproteinreceptor-1 (sLOX-1) for stroke was unclearly. This study aimed to investigate the association between sLOX-1 and recurrent stroke in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA).
Data were obtained from the Third China National Stroke Registry. Eligible cases consisted of 400 patients who developed recurrent stroke within 1-year follow-up, 800 controls were selected using age- and sex-matched with a 1:2 case-control ratio. Conditional logistic regressions were used to evaluate the association between sLOX-1 and recurrent stroke.
Among 1200 patients included in this study, the median (interquartile range) of sLOX-1 was 247.12 (132.81-413.58) ng/L. After adjustment for conventional confounding factors, the odds ratio with 95% confidence interval in the highest tertile versus the lowest tertile was 2.23 (1.61-3.08) for recurrent stroke, 2.31 (1.64-3.24) for ischemic stroke, 2.30 (1.66-3.19) for combined vascular events within 1-year follow-up. Furthermore, the addition of sLOX-1 to a conventional risk model had an incremental effect on predictive value for recurrent stroke (C-statistics 0.76, p < 0.0001; integrated discrimination improvement 13.38%, p < 0.0001; net reclassification improvement 55.39%, p < 0.0001). Similar results were observed when the timepoint was set up as 3 months. Subgroup analysis showed the association between higher sLOX-1 and recurrent stroke was more pronounced in patients with a history of stroke (p for interaction = 0.0062).
sLOX-1 was positively associated with the risk of recurrent stroke, which may be a candidate biomarker to improve risk stratification of recurrent stroke.
可溶性凝集素样氧化低密度脂蛋白受体-1（sLOX-1）对中风的预后价值尚不清楚。本研究旨在探讨急性缺血性中风（AIS）或短暂性脑缺血发作（TIA）患者中 sLOX-1 与复发性中风之间的关系。
数据来自第三次中国国家中风登记研究。合格病例包括在 1 年随访内发生复发性中风的 400 例患者，使用年龄和性别匹配的 1:2 病例对照比选择 800 例对照。使用条件逻辑回归评估 sLOX-1 与复发性中风之间的关系。
在纳入本研究的 1200 例患者中，sLOX-1 的中位数（四分位距）为 247.12（132.81-413.58）ng/L。在校正常规混杂因素后，最高三分位与最低三分位相比，复发性中风、缺血性中风、1 年内联合血管事件的比值比及其 95%置信区间分别为 2.23（1.61-3.08）、2.31（1.64-3.24）、2.30（1.66-3.19）。此外，sLOX-1 加入传统风险模型对复发性中风的预测价值具有增量作用（C 统计量 0.76，p<0.0001；综合判别改善 13.38%，p<0.0001；净重新分类改善 55.39%，p<0.0001）。当时间点设置为 3 个月时，观察到类似的结果。亚组分析表明，sLOX-1 与复发性中风之间的关联在有中风病史的患者中更为显著（p 交互 = 0.0062）。
sLOX-1 与复发性中风的风险呈正相关，可能是改善复发性中风风险分层的候选生物标志物。
