Yuan Wanzhong, Huo Ran, Hou Chaofan, Bai Wenbin, Yang Jun, Wang Tao
Department of Neurosurgery, Peking University Third Hospital, Beijing 100191, China.
Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
Diagnostics (Basel). 2023 Oct 12;13(20):3196. doi: 10.3390/diagnostics13203196.
To investigate the differences in serum iron index and iron metabolizing protein expression in plaques in patients with different degrees of carotid artery stenosis and the relationship with plaque traits.
A total of 100 patients eligible for carotid endarterectomy (CEA) from August 2021 to February 2022 were included. Patients completed a computed tomography (CTA) scan for patient grouping and a magnetic resonance imaging (MRI) for precise quantification of carotid plaque traits within 1 week prior to surgery. Clinical indicators associated with the progression of carotid stenosis to occlusion were analyzed using ordered logistic regression. Twenty carotid plaques were analyzed immunohistochemically to investigate the relationship between plaque traits and the iron metabolism indexes.
No significant correlation between high serum ferritin (SF), unsaturated iron binding capacity (UIBC) and progression of carotid stenosis (OR 1.100, 95% CI 0.004-0.165, = 0.039; OR 1.050, 95% CI 0.005-0.094, = 0.031). SF and serum transferrin receptor (sTfR) were correlated with normalized wall index (NWI) (R = 0.470, = 0.036; R = 0.449, = 0.046), and the results of multiple linear regression suggested that SF and sTfR remained associated with NWI (R = 0.630, R = 0.397, Adjusted R = 0.326, = 0.014). In plaques, H-type ferritin (H-FT) was correlated with NWI and lipid-rich necrotic core (LRNC) volume (R = 0.502, = 0.028; R = 0.468, = 0.043). Transferrin receptor 1 (TfR1) was correlated with LRNC volume and intraplaque hemorrhage (IPH) volume (R = 0.538, = 0.017; R = 0.707, = 0.001).
There were statistical differences in the expression of iron metabolism proteins in carotid plaques with different degrees of stenosis. Serum iron metabolism index (SF and sTfR) and expression of iron metabolizing proteins (H-FT and TfR1) in plaques were positively correlated with carotid plaque vulnerability index (NWI, LRNC volume).
探讨不同程度颈动脉狭窄患者斑块中血清铁指标及铁代谢蛋白表达的差异及其与斑块特征的关系。
纳入2021年8月至2022年2月符合颈动脉内膜切除术（CEA）条件的100例患者。患者在手术前1周内完成计算机断层扫描（CTA）以进行分组，并完成磁共振成像（MRI）以精确量化颈动脉斑块特征。使用有序逻辑回归分析与颈动脉狭窄进展至闭塞相关的临床指标。对20个颈动脉斑块进行免疫组织化学分析，以研究斑块特征与铁代谢指标之间的关系。
高血清铁蛋白（SF）、不饱和铁结合能力（UIBC）与颈动脉狭窄进展之间无显著相关性（OR 1.100，95%CI 0.004 - 0.165，P = 0.039；OR 1.050，95%CI 0.005 - 0.094，P = 0.031）。SF和血清转铁蛋白受体（sTfR）与标准化管壁指数（NWI）相关（R = 0.470，P = 0.036；R = 0.449，P = 0.046），多元线性回归结果表明SF和sTfR仍与NWI相关（R = 0.630，R = 0.397，调整后R = 0.326，P = 0.014）。在斑块中，H型铁蛋白（H-FT）与NWI和富含脂质坏死核心（LRNC）体积相关（R = 0.502，P = 0.028；R = 0.468，P = 0.043）。转铁蛋白受体1（TfR1）与LRNC体积和斑块内出血（IPH）体积相关（R = 0.538，P = 0.017；R = 0.707，P = 0.001）。
不同狭窄程度的颈动脉斑块中铁代谢蛋白的表达存在统计学差异。血清铁代谢指标（SF和sTfR）及斑块中铁代谢蛋白（H-FT和TfR1）的表达与颈动脉斑块易损性指标（NWI、LRNC体积）呈正相关。
