The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.
Yichang Central People's Hospital, Yichang, China.
BMC Cardiovasc Disord. 2022 Dec 6;22(1):523. doi: 10.1186/s12872-022-02969-z.
Timely detection of cerebral infarction is of vital importance in planning intervention effect of rapid rehabilitation. The clinical auxiliary diagnosis value of single biomarker, including small dense low-density lipoprotein concentration (sdLDLc), homocysteine concentration (HCYc) and high-density lipoprotein cholesterol concentration (HDLc) for cerebral infarction has been confirmed by many studies. Whether the use of three biomarkers in combination by calculating (sdLDLcHCYc)/HDLc ratio could improve the diagnosis ability for primary cerebral infarction remains to be unclear. In the present study, we conducted a cross-sectional study to evaluate the value of (sdLDLcHCYc)/HDLc ratio in clinical auxiliary diagnosis of primary cerebral infarction.
A total of 583 participants, including 299 healthy participants as control group and 284 participants diagnosed with first cerebral infarction as experiment group, were included in this respective study. The serum sdLDLc, HDLc and HCYc were measured by peroxidase method, enzyme-linked immunosorbent assay and an enzymatic method, respectively.
The average concentration of sdLDL and HCY (0.69 ± 0.29 mmol/L and 18.14 ± 6.62 μmol/L) in experiment group was significantly higher than those in the control group (0.55 ± 0.22 mmol/L and 10.77 ± 2.67 μmol/L, P < 0.05). However, the average concentration of HDL (1.47 ± 0.25 mmol/L) in the control group was higher than that in the experiment group (1.33 ± 0.28 mmol/L, P < 0.05). Spearman correlation coefficient showed the three indicators are independent of each other. The positive predictive value of (sdLDLcHCYc)/HDLc ratio (61.27%, 95% CI: 55.31-66.92) is higher than that in single biomarker (sdLDLc: 6.69 95% CI: 4.19-10.42, HCYc: 38.38%, 95% CI: 32.75-44.33, HDLc: 3.87%, 95% CI: 2.05-7.02). Receiver-operating characteristic curve (ROC) analysis illustrated that predictive power of (sdLDLcHCYc)/HDLc was higher than single biomarker, including sdLDLc, HCYc and HDLc, in primary cerebral infarction.
Therefore, (sdLDLc*HCYc)/HDLc ratio might be a better new indicator in clinical auxiliary diagnosis of primary cerebral infarction, which could be contributed to predicting cerebral infarction occurrence and provide a scientific basis for early prevention.
及时发现脑梗死对规划快速康复的干预效果至关重要。许多研究已经证实，小而密低密度脂蛋白浓度（sdLDLc）、同型半胱氨酸浓度（HCYc）和高密度脂蛋白胆固醇浓度（HDLc）等单一生物标志物对脑梗死的临床辅助诊断具有价值。但是，使用三种生物标志物（sdLDLcHCYc）/HDLc 比值联合计算是否可以提高原发性脑梗死的诊断能力尚不清楚。在本研究中，我们进行了一项横断面研究，以评估（sdLDLcHCYc）/HDLc 比值在原发性脑梗死临床辅助诊断中的价值。
共纳入 583 名参与者，其中 299 名健康参与者作为对照组，284 名被诊断为首次脑梗死的参与者作为实验组。分别采用过氧化物酶法、酶联免疫吸附法和酶法测定血清 sdLDLc、HDLc 和 HCYc。
实验组 sdLDL 和 HCY 的平均浓度（0.69±0.29mmol/L 和 18.14±6.62μmol/L）明显高于对照组（0.55±0.22mmol/L 和 10.77±2.67μmol/L，P<0.05）。然而，对照组 HDL 的平均浓度（1.47±0.25mmol/L）高于实验组（1.33±0.28mmol/L，P<0.05）。Spearman 相关系数显示，这三个指标相互独立。（sdLDLcHCYc）/HDLc 比值的阳性预测值（61.27%，95%CI：55.31-66.92）高于单一生物标志物（sdLDLc：6.69%，95%CI：4.19-10.42；HCYc：38.38%，95%CI：32.75-44.33；HDLc：3.87%，95%CI：2.05-7.02）。受试者工作特征曲线（ROC）分析表明，（sdLDLcHCYc）/HDLc 比值对原发性脑梗死的预测能力高于 sdLDLc、HCYc 和 HDLc 等单一生物标志物。
因此，（sdLDLc*HCYc）/HDLc 比值可能是原发性脑梗死临床辅助诊断的一个更好的新指标，有助于预测脑梗死的发生，并为早期预防提供科学依据。
