| Objective:To investigate the level of serum Sestrin2 testing in patients with acute ischemic stroke,and to explore the value of Sestrin2 in evaluating the prognosis of patients with acute ischemic stroke.Methods:Recorded for a consecutive series of adult patients with ischemic stroke in the Affiliated Hospital of Yanbian University Department of Neurology from September 2016 to January 2017(n = 88),male(n = 45)and female(n = 43),mean age(59.06 ± 3.41)years.A random sample of the same period with an equal number of age and gender matched non stroke individuals(n = 88),including male(n = 46),and female(n = 42),average age(5 8.68±3.36)years old.Assessment of the severity of acute ischemic stroke patients,We measured National Institutes of Health Stroke Scale(NIHSS)to evaluate the degree of neural function defect,the results were divided into mild group(NIHSS?3),medium group(NIHSS 4-8),severe group(NIHSS>8).Stroke subtype was classified using the Trial of Org 10172 in Acute Stroke Treatment(TOAST)criteria.The patients with ischemic stroke were divided into 4 subtypes:large artery atherosclerosis,arterial occlusion,cardioembolism and stroke of undetemined etiology.According to the modified Rankin(mRS)score,follow up was possible on patients with ischemic stroke of post-discharge and after 3 months,the daily living ability or dependency assessment,divided into good prognosis group(mRS 0?2 score)and poor prognosis group(mRS 3?5).The concentration of serum Sestrin2(SESN2)was detected by ELISA method.Results:1.Ischemic stroke group and control group general information comparison showed that there are statistically significant differences bwteen the two groups of hypertension,diabetes,dyslipidemia,smoking,drinking,TG,LDL-C,GLU,HCY,Hs-CRP levels were significantly higher in patients with ischemic stroke(P<0.05).However,the levels of HDL-C were significantly lower than the control group(P<0.05).There are no significant differences between two groups in gender,age,BMI,pulse and TC levels(P>0.05)?2.Compared with the control group,the levels of serum Sestrin2 of patients with ischemic stroke were significantly higher(13.85±3.OOng/ml vs.11.91 ± 1.95ng/ml,P=0.001).3.The content of serum Sestrin2 and ischemic stroke severity,correlation analysis showed that serum Sestrin2 content in the NHISS score of light,heavy,there were no significant difference between the three groups(F=1.700,P=0.189);Among four groups of TOSAT type serum Sestrin2 content had no significant difference(F=0.728,P=0.538).4.The correlation between the level of serum Sestrin2 and prognosis of ischemic stroke showed that there was no associated with Sestrin2 testing between the good prognosis group and the poor prognosis group(P=0.276).5.Correlation analyses were used to identify patient characteristics associated with elevated Sestrin2 levels and factors associated with Sestrin2 testing.Respectively,in patients with ischemic stroke or in the control group,serum Sestrin2 testing were positively correlated with blood glucose(r = 0.254,P = 0.017;r = 0.229,P = 0.032).Compared without related disease history,the level of serum Sestrin2 were significantly higher in patients with ischemic stroke with diabetes,smoking and drinking(P=0.01,?P=0.0011,P =0.009).6.Multivariable stepwise logistic regression analyses were then used to identify the independent associations of univariately significant variables with Sestrin2 testing and other stroke risk factors.They were independently associated with in patients with ischemic stroke,Sestrin2(OR=0.791,95%CI= 0.647 to 0.966,P=0.022),Hs-CRP(OR=0.485,95%CI= 0.329 to 0.717,P<0.001),hyperlipidemia(OR=4.290,95%CI=1.517 to 12.131,P=0.006)respectively.7.According to the result of Logistic model,Sestrin2,Hs-CRP,HCY constructed by ROC curve showed that the area under the curve of Sestrin2(OR=0.705,95%CI=0.628 to 0.782,P=0.002),cut off=13.150,the sensitivity was 77.3%,the specificity was 55.7%.The area under the curve of Hs-CRP(OR=0.767,95%CI=0.697 to 0.837,P<0.001),cut off ? 1.245,the sensitivity was 81.8%and the specificity was 64.8%.The area under the curve of HCY(OR=0.580,95%CI=0.495 to 0.666,P=0.065),cut off = 12.245,the sensitivity was 44.6%and the specificity was 71.6%.Conclusion:1.Our findings indicate that possible association between elevated Sestrin2 levels in patients with ischemic stroke.It suggests that Sestrin2 is involved in the pathogenesis of acute ischemic stroke.2.Elevated Sestrin2 levels were positively associated with blood glucose of ischemic stroke patients and the non-stroke individual.3.The level of serum Sestrin2 in patients with diabetes mellitus,smoking,and alcoholism was significantly higher than that of patients without medical history.4.This study shows that the level of serum is an independent risk factors for stroke.5.Serum Sestrin2 testing is a potential biomarker for diagnosis and prevention of ischemic stroke. |
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