Shen Huimin, Huang Anyan, Wang Bingxin, Huang Xiaohua, Chen Ruiqian
Department of Brain Center, People's Hospital of Chenghai District, Shantou, Guangdong, China.
Department of Health Care, Shantou Maternal and Child Health Hospital, Shantou, Guangdong, China.
Front Endocrinol (Lausanne). 2025 Apr 17;16:1546961. doi: 10.3389/fendo.2025.1546961. eCollection 2025.
To evaluate the clinical significance of human plasma lipoprotein-associated phospholipase A2 (Lp-PLA2), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high-sensitivity C-reactive protein (hs-CRP), leukocyte count, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) in patients with Type 2 diabetes mellitus (T2DM) and acute ischemic stroke (AIS).
A total of 155 T2DM patients with AIS, admitted to the Second Affiliated Hospital of Shantou University Medical College between October 2023 and October 2024, were included in the stroke group. Additionally, 86 T2DM subjects from the same period were included in the T2DM control group. Serum levels of Lp-PLA2, LDL-C, HDL-C, hs-CRP, leukocyte count, FPG, and HbA1c were compared between the T2DM-AIS group and the T2DM control group, as well as among T2DM-AIS patients with different infarct sizes and degrees of neurological impairment. The clinical value of the above indexes in the diagnosis of T2DM with AIS was analyzed by receiver operating characteristic curve (ROC curve).
Serum levels of Lp-PLA2 (142.9 [115.8, 178.3] ng/L), LDL-C (3.4 [2.6, 4.2] mmol/L), hs-CRP (3.6 [1.5, 11.2] mg/L), leukocytes (8.0 [6.8, 10.3] × 10^9/L), FPG (10.2 [7.5, 14.4] mmol/L), and HbA1c (10.2 [7.5, 14.4] %) were significantly higher in the T2DM-AIS group compared to the T2DM control group (Lp-PLA2: 102.1 [76.6, 121.9] ng/L, LDL-C: 3.2 [2.4, 3.7] mmol/L, hs-CRP: 2.4 [0.9, 5.2] mg/L, leukocytes: 7.0 [6.1, 8.1] × 10^9/L, FPG: 7.4 [6.1, 10.3] mmol/L, HbA1c: 7.0 [6.4, 8.2] %). In contrast, serum HDL-C levels (1.1 [0.9, 1.3] mmol/L) were significantly lower than those in the control group (1.3 [1.1, 1.5] mmol/L), which correlated with larger infarct size and greater neurological injury. ROC curve analysis indicated that the combined use of seven tests had an AUC of 0.906, with a sensitivity of 77.40% and a specificity of 95.30%.
Monitoring serum levels of Lp-PLA2, LDL-C, HDL-C, hs-CRP, leukocyte count, FPG, and HbA1c provides a comprehensive assessment of cerebral infarction in T2DM patients with AIS and serves as auxiliary indicators for evaluating disease severity.
评估人血浆脂蛋白相关磷脂酶A2（Lp-PLA2）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、高敏C反应蛋白（hs-CRP）、白细胞计数、空腹血糖（FPG）和糖化血红蛋白（HbA1c）在2型糖尿病（T2DM）合并急性缺血性脑卒中（AIS）患者中的临床意义。
2023年10月至2024年10月期间入住汕头大学医学院第二附属医院的155例T2DM合并AIS患者被纳入卒中组。此外，同期86例T2DM受试者被纳入T2DM对照组。比较T2DM-AIS组与T2DM对照组以及不同梗死面积和神经功能缺损程度的T2DM-AIS患者之间的血清Lp-PLA2、LDL-C、HDL-C、hs-CRP、白细胞计数、FPG和HbA1c水平。通过受试者工作特征曲线（ROC曲线）分析上述指标在T2DM合并AIS诊断中的临床价值。
T2DM-AIS组的血清Lp-PLA2（142.9 [115.8, 178.3] ng/L）、LDL-C（3.4 [2.6, 4.2] mmol/L）、hs-CRP（3.6 [1.5, 11.2] mg/L）、白细胞（8.0 [6.8, 10.3]×10^9/L）、FPG（10.2 [7.5, 14.4] mmol/L）和HbA1c（10.2 [7.5, 14.4]%）水平显著高于T2DM对照组（Lp-PLA2：102.1 [76.6, 121.9] ng/L，LDL-C：3.2 [2.4, 3.7] mmol/L，hs-CRP：2.4 [0.9, 5.2] mg/L，白细胞：7.0 [6.1, 8.1]×10^9/L，FPG：7.4 [6.1, 10.3] mmol/L，HbA1c：7.0 [6.4, 8.2]%）。相比之下，血清HDL-C水平（1.1 [0.9, 1.3] mmol/L）显著低于对照组（1.3 [1.1, 1.5] mmol/L），且与更大的梗死面积和更严重的神经损伤相关。ROC曲线分析表明，七项检测联合使用的AUC为0.906，灵敏度为77.40%，特异性为95.30%。
监测血清Lp-PLA2、LDL-C、HDL-C、hs-CRP、白细胞计数、FPG和HbA1c水平可为T2DM合并AIS患者的脑梗死提供全面评估，并作为评估疾病严重程度的辅助指标。
