Chen Zhuo, Cao Tianli, Zhong Xingju, Wu Yong, Fu Wei, Fan Chaoli, Jiang Yu, Zhou Qi, Peng Jie, Liao Jieyu, You Zhike, Yi Xin, Tan Jingyu
Department of Neurology, Mianzhu People's Hospital, Mianzhu, China.
Department of Endocrinology, Mianzhu People's Hospital, Mianzhu, China.
Front Neurol. 2022 Aug 24;13:953557. doi: 10.3389/fneur.2022.953557. eCollection 2022.
Experimental studies demonstrated that netrin-1 (NT-1) has anti-inflammatory, tissue regeneration, and immune modulation properties. We aimed to discern the utility of NT-1 as a biomarker for assessing the risk of early neurological deterioration (END) after ischemic stroke.
This was a prospective study enrolling ischemic stroke patients with symptoms onset <24 h. Serum NT-1 concentrations were measured at admission. The National Institutes of Health Stroke Scale increased by ≥2 points and ≥4 points during the first 72 h after admission and was defined as END2 and END4, respectively.
The study included 268 patients (146 men and 122 women) with a mean age of 63.0 ± 9.6 years. The median NT-1 concentrations were 466.4 pg/ml (interquartile range, 341.4-589.2 pg/ml). During the initial 72 h after admission, END2 was found in 83 (31.0%) patients, and END4 was observed in 48 (17.9%) subjects. After adjusted for potential confounders, multivariate analysis indicated that decreased NT-1 levels is an independent predictor for END2 [odds ratio () 0.62, 95% confidence interval () 0.46-0.84, < 0.001) and END4 ( 0.53, 95% 0.36-0.76, < 0.001). Similar results were found when the NT-1 levels were analyzed as a categorical variable. Furthermore, restricted cubic spline analysis showed a linear association between NT-1 concentrations and the risk of END (END2, = 0.006 for linearity; END4, < 0.001 for linearity).
Our results suggest that decreased NT-1 levels were significantly associated with a higher risk of END after ischemic stroke.
实验研究表明，网蛋白-1（NT-1）具有抗炎、组织再生和免疫调节特性。我们旨在探讨NT-1作为评估缺血性中风后早期神经功能恶化（END）风险生物标志物的效用。
这是一项前瞻性研究，纳入症状发作时间<24小时的缺血性中风患者。入院时测定血清NT-1浓度。美国国立卫生研究院卒中量表在入院后最初72小时内增加≥2分和≥4分，分别定义为END2和END4。
该研究纳入了268例患者（146例男性和122例女性），平均年龄为63.0±9.6岁。NT-1浓度中位数为466.4 pg/ml（四分位间距，341.4 - 589.2 pg/ml）。入院后最初72小时内，83例（31.0%）患者出现END2，48例（17.9%）患者出现END4。在调整潜在混杂因素后，多变量分析表明NT-1水平降低是END2（比值比[OR] 0.62，95%置信区间[CI] 0.46 - 0.84，P < 0.001）和END4（OR 0.53，95% CI 0.36 - 0.76，P < 0.001）的独立预测因素。将NT-水平作为分类变量分析时也发现了类似结果。此外，限制性立方样条分析显示NT-1浓度与END风险之间存在线性关联（END2，线性P = 0.006；END4，线性P < 0.001）。
我们的结果表明，NT-1水平降低与缺血性中风后END风险较高显著相关。
