Correlation Study Of Elevated High Sensitive C Reactive Protein Levels And Increased Risk Of Intracranial Arterial Stenosis

Objective: Intracranial artery stenosis(ICAS)is the common cause of ischemic stroke around the world.ischemic stroke caused by intracranial vascular stenosis can still face a high risk of recurrence even with better integrated medical treatment,which may be closely linked to the failure to identify potential stroke mechanisms and the lack of personalized treatment.Studies have shown that high sensitive C-reactive protein(hs-CRP),as an acute phase-responsive inflammatory biomarker mainly produced by hepatocytes,is closely linked to the formation of atherosclerotic plaques.But studies on the association of elevated hs-CRP levels with intracranial artery stenosis(ICAS)are still uncorrected.The present study aimed to explore the association of hs-CRP levels with the occurrence of ICAS in stroke and non-stroke populations,in order to provide a reasonable and accurate predictor for the effective assessment of stroke and non-stroke intracranial artery stenosis.Method: The subjects included in the study were patients with stroke and individuals receiving comprehensive health screening in the Department of Neurology,Qingdao City Hospital from January 2014 to June 2018.A total of 1458 participants with age ≥ 40 years were included in this study.All of the participants have completed magnetic resonance angiography(MRA)and magnetic resonance diffusion-weighted imaging(DWI)to assess ICAS and acute cerebral infarction.Furthermore,among all participants,participants were excluded when they have acute infection and severe liver disease which can affect hs-CRP levels,and participants with atrial fibrillation and other factors which can lead to stroke and ICAS.The hs-CRP level and biochemical factors were determined after the blood samples were collected,and the relevant data of clinical history were extracted by the relevant records in the medical record system.R software was used for statistical analysis.All participants were divided into four groups based on stroke and ICAS status: stroke with ICAS group,stroke without ICAS group,non-stroke with ICAS group,non-stroke without ICAS group.The measurement data were expressed by the median(upper and lower quartiles),the difference between the two groups was compared by the Wilcoxon test;the chi-square test was used for the inter-group comparison of the counting data.The multivariable Logistic regression model was also performed to assess the relationship between hs-CRP levels and ICAS status.P < 0.05 was statistically significant.Results: A total of 432(29.63%)subjects had ICAS,including 297 stroke patients and 135 non-stroke patients.Hs-CRP levels were significantly higher in the stroke group than in the non-stroke group(stroke group: 3.11 mg/L;non-stroke group: 1.68 mg/L;P < 0.001).patients with intracranial arterial stenosis had higher hs-CRP levels than non-cranial arterial stenosis(P < 0.001).In univariate Logistic regression analysis,age,blood glucose,hs-CRP,medical history of diabetes and hypertension were the risk factors for ICAS.In the multivariate Logistic analysis corrected for other risk factors,four groups were divided according to the quartile of hs-CRP concentration,the highest concentration of hs-CRP group had the strongest correlation with ICAS(stroke group,OR = 2.386,95%CI was 1.559–3.678,P < 0.001;non-stroke group OR = 2.325,95% CI was 1.307–4.240,P = 0.005).Conclusion and significance: In this study we found that elevated serum hs-CRP levels were closely associated with the prevalence of ICAS,both in stroke patients and non-stroke participants.And,along with the elevated serum hs-CRP levels,the risk of ICAS occurring gradually increased.This reminds us that elevated serum hs-CRP level may play a predictive role in the prevalence of ICAS in both healthy population and stroke patients.