Correlation Analysis Of Serum Endocan Levels With Different Subtypes Of Isolated Penetrating Artery Territory Ischemic Stroke

Objective: Ischemic stroke is caused by localized blood supply disorders,and perforating artery infarct(PAI)is one of the important clinical phenotypes of ischemic stroke.However,clinical manifestation of PAI is all sorts or varieties and mechanism of PAI is complicated.The aim of this study is to investigate the correlation between serum endothelial cell specific molecule-1(ESM-1/Enodcan)levels and different types of single PAI.Methods: Patients with first acute ischemic stroke(AIS)hospitalized in the First Department of Neurology,Shengjing Hospital,China Medical University from September 2021 to December 2022 were chosen as subjects.According to inclusion and excluding criteria,patients with single PAI who were identified by imaging procedures or blood tests constituted the case group,which was separated into further groups.And the control group was composed of healthy persons with normal test results.Serum ESM-1 levels were measured by enzyme-linked immune sorbent assay(ELISA).Finally,the general materials,clinical characteristics,and serum ESM-1 levels of all subjects were analyzed using method of statistics.Results: Ninety-seven patients with single PAI were selected and divided into branch atheromatous disease(BAD)group and lipohyalinotic degeneration(LD)group.Twenty-six healthy subjects were selected as the control group.Compared to healthy subjects,patients with isolated PAI have higher serum ESM-1 levels(P=0.000).Single factor analysis showed that there were significant differences in serum cystatin-c(CYS-C)levels(P=0.017),homocysteine(HCY)levels(P=0.017),total cholesterol(TC)levels(P=0.000),low-density lipoprotein cholesterol(LDL-C)levels(P=0.000),glycosylated hemoglobin levels(P=0.033),and ESM-1 levels(P=0.000)among BAD group and LD group.Besides,imaging manifestations were significantly different between the two groups in terms of the incidence of lacune(P=0.044),severe cerebral white matter hyperintensities(WMH)(P=0.001),and moderate-severe enlarged perivascular space(e PVS)(P=0.000).Logistic regression analysis showed that the incidence of WMH(P=0.038),e PVS(P=0.029),and serum ESM-1 levels(P=0.000)still had statistical difference between BAD group and LD group.The ROC curve analysis showed that serum ESM-1 levels could be used to predict BAD(P=0.000).The optimal cut-off value was 97.04ng/ml.Conclusions: 1.The incidence of WMH,e PVS,and serum ESM-1 levels are significantly different in patients with BAD versus LD.2.Serum ESM-1 levels are significantly higher in patients with single PAI compared with healthy subjects.3.Serum ESM-1 levels have important value in diagnosing and classifying PAI.BAD has higher serum ESM-1 levels than LD.