Study On The Combined Use Of Serum Levels Of SLox-1 And Lp-PLA2 And Acute Cerebral Infarction And Cerebrovascular Stenosis

Objective: The aim of this study was to demonstrate the correlation between serum levels of soluble lectin-like oxidized low-density lipoprotein receptor-1（s LOX-1）and lipoprotein-associated phospholipase A2（Lp-PLA2）and cerebrovascular stenosis in acute cerebral infarction（ACI）and the clinical value in predicting the prognosis.Materials and methods: A total of 127 ACI patients and 38 healthy controls were included in this prospective observational study.The concentrations of s LOX-1 and Lp-PLA2 in serum were measured and their relationship with a poor prognosis（modified Rankin score>2）90 days after the onset of ACI was analyzed.Spearman correlation analysis was used to determine the relationship between s LOX-1 and Lp-PLA2 levels and adverse prognosis 90 days after onset.The independent correlation between poor prognosis and risk factors 90 days after onset was evaluated by binary logistic regression analysis.The predictive value of s LOX-1 and Lp-PLA2 for poor prognosis after 90 days of ACI was evaluated by receiver operating characteristic（ROC）curve analysis.Results: We found that the serum levels of s LOX-1 and Lp-PLA2 in ACI patients was significantly higher than those in the control group.The level of s LOX-1 in ACI with vascular stenosis group was significantly higher than that in ACI without vascular stenosis group（ACI with vascular stenosis group:1204.05±285.55ng/ml;ACI without vascular stenosis group 1064.53±242.86,P=0.026）,and the difference in Lp-PLA2 between the two groups was not statistically significant（ACI with vascular stenosis group: 135.88±55.89mg/L;ACI group without vascular stenosis: 133.74±59.35mg/L,P=0.871）.Patients with poor prognosis had higher mean serum levels s LOX-1（poor prognosis group:1333.95±290.94ng/ml;good prognosis group: 117.59±42.11ng/ml;P<0.001）and Lp-PLA2（poor prognosis group: 171.62±64.21mg/L;good prognosis group:117.59±42.11mg/L;P<0.001）.After adjusting confounders,serum levels of s LOX-1 and Lp-PLA2 were found to be associated with a poor prognosis（s LOX-1,odds ratio（OR）: 1.005,95% confidence interval（95%CI）,1.002-1.007,P<0.001;Lp-PLA2,OR:1.025,95%CI,1.013-1.036,P<0.001）.The level of s LOX-1 and Lp-PLA2 could predict the functional outcome of ACI.At the optimal cut-off value of s LOX-1 level（1257.92ng/ml）,the sensitivity and specificity for the poor functional outcome were 0.69 and 0.753,respectively,and the area under ROC curve（AUC）was 0.727.Similarly,the optimal value for Lp-PLA2 level was 136.46 ng/ml,at which the sensitivity and specificity were0.643 and 0.835,respectively;and the AUC was 0.758.When the two biomarkers were used in combination,the AUC was 0.855,and the sensitivity and specificity were 0.643 and 0.976,respectively,indicating a significant improvement of the diagnostic specificity.Conclusions: s LOX-1 and Lp-PLA2 serum levels were significantly higher in patients with poor prognosis than those in patients with good prognosis.The s LOX-1 in ACI group with vascular stenosis was significantly higher than that in ACI group without vascular stenosis,which may be related to the involvement of LOX-1 in mediating atherosclerotic plaque.The level of s LOX-1 or Lp-PLA2 could thus serve as useful biomarkers to predict the functional outcome of ACI.The combined use of both indicators is better than the use of either single indicator,and provides the highest specificity in predicting poor prognosis.