Analysis Of The Association Between Serum Alanine Aminotransferase And Ischemic Stroke

Background and objectivesIn recent years, the morbidity, mortality and disability rate of stroke increased gradually, which has become the second cause of human death and the first cause of human disability. Therefore, the prevention and treatment of stroke is more and more important to the clinical and scientific research workers. Research shows that smoking, hypertension, diabetes, dyslipidemia, atrial fibrillation, asymptomatic carotid artery stenosis, metabolic syndrome are independent risk factors of stroke, but the exact etiology and risk factors of stroke are not completely clear. With the progress of the research, The role of alanine aminotransferase(ALT) in the serum of liver enzyme in cardiovascular and cerebrovascular disease has aroused academic attention. The relevant research results at home and abroad are not entirely the same. Blood biochemistry, carotid artery ultrasound and nerve function assessment in patients with ischemic stroke are enrolled in the study, aimed at:1. Analysis of the correlation between serum ALT level and the incidence of ischemic stroke;2. Analysis of the correlation between serum ALT level and carotid artery stenosis;3. Analysis of the correlation between serum ALT levels and short-term prognosis in patients with ischemic stroke. MethodsThis study enrolled ischemic stroke patients admitted to department of neurology and neurological intensive care unit(NICU) in the First Affiliated Hospital of Zhengzhou University who have complete clinical data from January 2014 to January 2016. At the same time, the physical examination center healthy subjects in the same period are taken as the control group. The sex ratio and the age proportion were matched with the observation group. To investigate the correlation between the changes of serum ALT levels and the occurrence and short-term prognosis of ischemic stroke and carotid artery stenosis, provide new indexes for the diagnosis and treatment of ischemic stroke. Multivariate Logistic regression analysis is used to clarify whether serum ALT is a risk factor for stroke incidence, multiple linear regression is used to clarify whether serum ALT is a risk factor for analysis stroke prognosis. Results1. The levels of the known risk factors in ischemic stroke group were significantly different with the control group(P<0.05). The level of serum ALT in the ischemic stroke group was significantly higher than that in the control group(P<0.05).2. With the increase of quartiles of the ALT serum concentration, the number of most selected risk factors was also increased. In the univariate logistic regression analysis, it was found that the elevated serum ALT level was the risk factor for the onset of ischemic stroke(OR=2.40;95% CI :1.23-4.67;P=0.011). Further multivariate Logistic regression analysis revealed that the association was still statistically significant(OR=2.00;95% CI:1.01-3.96;P=0.047).3. According to multiple linear regression analysis, serum ALT level was positive correlated with IMT in women(B=0.003,P=0.010)and men(B=0.003,P=0.042), and with the increase of quartiles of the ALT serum concentration, the burden of IMT increased(P<0.05).4. Age, BMI, antihypertensive treatment, hypoglycemic therapy, serum ALT levels, admission NIHSS score, admission mRS score are significantly different(both P<0.05). Results of univariate logistic regression(OR=0.977;95%CI:0.996-0.999)and multivariate logistic regression analysis(OR =0.856;95%CI:0.795-0.898)revealed that gender, admission BMI, TC and TG are risk factors of ischemic stroke in patients with stroke prognosis, but serum ALT was the protective factor for the occurrence of stroke prognosis, the OR values were statistically significant(both P<0.05). Conclusions1. Elevated serum ALT level is a risk factor for the onset of ischemic stroke.2. Serum ALT level is positively correlated with the degree of carotid stenosis and the elevation in the level of ALT in serum increase the burden of IMT.3. Elevated serum ALT level is a protective factor for the prognosis of ischemic stroke patients.