Zhang Xiyue
Department of Neurology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
J Neurochem. 2025 Jun;169(6):e70119. doi: 10.1111/jnc.70119.
This paper aimed to disclose the correlation of high-density lipoprotein cholesterol (HDL-C)-carried microRNA-28-5p (miR-28-5p) with acute ischemic stroke (AIS). This study retrospectively included 216 first-diagnosed AIS patients (study subjects) and 102 healthy people (controls). Clinical data, serum total cholesterol (TC), triglycerides (TG), glucose, homocysteine (Hcy), HDL-C, low-DL-C (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and fasting serum samples were collected. Serum miR-28-5p levels and disease severity were assessed by RT-qPCR and National Institutes of Health Stroke Scale (NIHSS). The diagnostic efficacy of miR-28-5p and Hcy for AIS and disease severity was evaluated using ROC curves. miR-28-5p was upregulated in AIS patients, positively correlated with HDL-C (p < 0.001, r = 0.848), and negatively correlated with TC (p < 0.001, r = 0.673). HDL-C-carried miR-28-5p was an independent influencing factor for AIS (p = 0.027, OR = 1.294, 95% CI = 1.030-1.626) and helped diagnose AIS (AUC = 0.938, 95% CI = 0.912-0.963). miR-28-5p was positively correlated with NIHSS scores (p < 0.001, r = 0.777) in AIS patients, and provided diagnostic value for AIS (positive predictive value [PPV] = 96.907%, negative predictive value [NPV] = 77.419%) and AIS severity (PPV = 95.200%, NPV = 75.824%). PPV > 95% and NPV < 90% suggested that miR-28-5p offered auxiliary diagnostic value for AIS and its severity, with limited diagnostic accuracy, and there might be a relatively high risk of missed diagnosis. The combination of miR-28-5p and Hcy improved the diagnostic value of miR-28-5p alone for AIS and its severity. Collectively, HDL-C-carried miR-28-5p is highly expressed in AIS patients and positively correlated with NIHSS score. It is an independent influencing factor for AIS and may assist in diagnosing AIS and its severity. Additionally, miR-28-5p combined with Hcy can increase the diagnostic value of miR-28-5p single detection for AIS and its severity.
本文旨在揭示高密度脂蛋白胆固醇（HDL-C）携带的微小RNA-28-5p（miR-28-5p）与急性缺血性脑卒中（AIS）之间的相关性。本研究回顾性纳入了216例首次诊断为AIS的患者（研究对象）和102名健康人（对照组）。收集了临床资料、血清总胆固醇（TC）、甘油三酯（TG）、血糖、同型半胱氨酸（Hcy）、HDL-C、低密度脂蛋白胆固醇（LDL-C）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）以及空腹血清样本。通过逆转录定量聚合酶链反应（RT-qPCR）和美国国立卫生研究院卒中量表（NIHSS）评估血清miR-28-5p水平和疾病严重程度。使用受试者工作特征曲线（ROC曲线）评估miR-28-5p和Hcy对AIS及疾病严重程度的诊断效能。miR-28-5p在AIS患者中上调，与HDL-C呈正相关（p＜0.001，r = 0.848），与TC呈负相关（p＜0.001，r = 0.673）。HDL-C携带的miR-28-5p是AIS的独立影响因素（p = 0.027，OR = 1.294，95%置信区间[CI] = 1.030 - 1.626），有助于诊断AIS（曲线下面积[AUC] = 0.938，95% CI = 0.912 - 0.963）。在AIS患者中，miR-28-5p与NIHSS评分呈正相关（p＜0.001，r = 0.777），并为AIS（阳性预测值[PPV] = 96.907%，阴性预测值[NPV] = 77.419%）及其严重程度（PPV = 95.200%，NPV = 75.824%）提供诊断价值。PPV＞95%且NPV＜90%表明miR-28-5p对AIS及其严重程度具有辅助诊断价值，但诊断准确性有限，可能存在相对较高的漏诊风险。miR-28-5p与Hcy联合使用可提高miR-28-5p单独对AIS及其严重程度的诊断价值。总体而言，HDL-C携带的miR-28-5p在AIS患者中高表达，与NIHSS评分呈正相关。它是AIS的独立影响因素，可能有助于诊断AIS及其严重程度。此外，miR-28-5p与Hcy联合使用可提高miR-28-5p单项检测对AIS及其严重程度的诊断价值。
