Anwar Luqman, Ahmad Ejaz, Imtiaz Muhammad, Ahmad Bilal, Awais Ali Muhammad
Neurology, Mayo Hospital Lahore, Lahore, PAK.
Neurology, Sir Ganga Ram Hospital, Lahore, PAK.
Cureus. 2024 Oct 1;16(10):e70624. doi: 10.7759/cureus.70624. eCollection 2024 Oct.
Stroke remains a leading cause of mortality and disability worldwide. Identifying reliable biomarkers for stroke diagnosis and risk prediction could significantly improve patient outcomes through earlier intervention and better risk management. The objective of this systematic review is to systematically review recent studies investigating biomarkers for stroke diagnosis and risk prediction and to synthesize the most promising findings. We conducted a systematic review of 10 studies published between 2008 and 2023 that examined various biomarkers in relation to stroke. Studies were evaluated for quality using a simplified version of the Mixed Methods Appraisal Tool. The reviewed studies investigated a diverse array of biomarkers, including lipids, inflammatory markers, hemodynamic markers, microRNAs, metabolites, and neurodegenerative markers. Key findings include the following: (1) non-traditional lipid markers such as triglycerides and non-high-density lipoprotein cholesterol may be more predictive of stroke risk than low-density lipoprotein; (2) inflammatory markers, particularly IL-6, showed strong associations with stroke risk; (3) hemodynamic markers like midregional proatrial natriuretic peptide (MRproANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) demonstrated potential in distinguishing stroke subtypes; (4) specific microRNAs (miR-125a-5p, miR-125b-5p, miR-143-3p) were upregulated in acute ischemic stroke; (5) metabolomic studies identified novel markers such as tetradecanedioate and hexadecanedioate associated with cardioembolic stroke; (6) neurodegenerative markers (total-tau, neurofilament light chain) were linked to increased stroke risk. This review highlights the potential of various biomarkers in improving stroke diagnosis and risk prediction. While individual markers show promise, a multi-marker approach combined with clinical variables appears most likely to yield clinically useful tools. Further large-scale validation studies are needed before these biomarkers can be implemented in routine clinical practice.
中风仍然是全球范围内导致死亡和残疾的主要原因。识别用于中风诊断和风险预测的可靠生物标志物，可通过早期干预和更好的风险管理显著改善患者预后。本系统评价的目的是系统回顾近期关于中风诊断和风险预测生物标志物的研究，并综合最有前景的研究结果。我们对2008年至2023年间发表的10项研究进行了系统评价，这些研究探讨了与中风相关的各种生物标志物。使用混合方法评估工具的简化版本对研究质量进行评估。纳入综述的研究调查了多种生物标志物，包括脂质、炎症标志物、血流动力学标志物、微小RNA、代谢物和神经退行性变标志物。主要研究结果如下：（1）甘油三酯和非高密度脂蛋白胆固醇等非传统脂质标志物可能比低密度脂蛋白更能预测中风风险；（2）炎症标志物，尤其是白细胞介素-6，与中风风险密切相关；（3）心房利钠肽前体中段（MRproANP）和N末端B型利钠肽原（NT-proBNP）等血流动力学标志物在区分中风亚型方面显示出潜力；（4）特定的微小RNA（miR-125a-5p、miR-125b-5p、miR-143-3p）在急性缺血性中风中上调；（5）代谢组学研究确定了与心源性栓塞性中风相关的新标志物，如十四烷二酸和十六烷二酸；（6）神经退行性变标志物（总tau蛋白、神经丝轻链）与中风风险增加有关。本综述强调了各种生物标志物在改善中风诊断和风险预测方面的潜力。虽然单个标志物显示出前景，但结合临床变量的多标志物方法似乎最有可能产生临床有用的工具。在这些生物标志物能够应用于常规临床实践之前，还需要进一步的大规模验证研究。
