Relationship Between S-Adenosylmethionine?S-Adenosylhomocysteine?Inflammatory Factors And Acute Ischemic Stroke

Objective: To investigate the relationship between the S-adenosylmethionine(SAM),S-adenosylhomocysteine(SAH),SAM / SAH,inflammatory factors and acute ischemic stroke(AIS).And providing new ideas for the prevention and treatment of AIS.Methods: This study included 123 AIS patients who were hospitalized in the Department of Neurology,the First Hospital of Hebei Medical University from June 2018 to October 2019 as the case group,and 125 non-stroke patients who were examined in our hospital at the same time were selected as the control group.Face-to-face questionnaires were used to collect general data of the two groups of subjects.Blood biochemical and routine blood test results at admission and physical examination were recorded.Physical examination of the two groups of subjects including height,weight,waist circumference,hip circumference and blood pressure.Patients also need to use the National Institutes of Health Stroke Scale(NIHSS)for disease severity scores,and according to the NIHSS score results were divided into two groups,scores <4 were divided into mild group,scores ? 4 were divided into moderate to severe group.In addition,enzyme-linked immunosorbent assay was used to detect serum oxidized low density lipoprotein cholesterol(ox-LDL),interleukin 6(IL-6),tumor necrosis factor ?(TNF-?),and intercellular adhesion molecule 1(ICAM-1),SAM and SAH.The latex turbidimetric method was used to detect the high-sensitivity C reactive protein(hs-CRP),the cyclic enzyme method was used to detect the homocysteine(Hcy).Results: Compared with control group,the number of people with a history of coronary artery disease,the number of alcohol drinkers,the number of people taking glucose-lowering drugs,the number of people taking lipid-lowering drugs,body mass index,fasting plasma glucose,triglyceride,total cholesterol,and low density lipoprotein cholesterol were no significant difference between the two groups(P>0.05).The number of people with a history of hypertension,the number of people with a history of diabetes,the number of people with a history of dyslipidemia,the number of smokers,the number of people taking antihypertensive drugs,waist-hip ratio,systolic blood pressure,diastolic blood pressure and ox-LDL in the case group were higher than those in the control group(P<0.05),and the level of high density lipoprotein cholesterol in the case group was lower than that in the control group(P<0.05).The serum levels of Hcy,SAM and SAM / SAH in the case group were higher than those in the control group,and the difference was statistically significant(P?0.05).The serum level of SAH was lower in the case group than in the control group,and the difference was statistically significant(P<0.05).The serum level of hs-CRP,ICAM-1,IL-6,TNF-?,blood neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)were higher in the case group than in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in serum Hcy,SAM,SAH and SAM / SAH between mild group and moderate to severe group(P>0.05).The levels of hs-CRP,TNF-?,NLR and PLR in the patients with moderate to severe group were higher than those in the mild group,and the difference was statistically significant(P<0.05),but there was no significant difference in serum IL-6 and ICAM-1 between the two groups(P>0.05).There was a positive correlation between TNF-?,NLR,PLR in patients with AIS and NIHSS scores(r = 0.194,P<0.05;r = 0.364,P<0.05 and r = 0.215,P<0.05).Logistic regression analysis was performed on the risk factors of AIS.After adjusting for other risk factors,the results showed that Hcy and SAM were risk factors for the occurrence of AIS(OR = 1.042,95% CI 1.008 to 1.077,P<0.05;OR = 1.018,95% CI 1.005 ? 1.032,P<0.05).Conclusions:1.Increased serum Hcy and SAM concentration are risk factors for the occurrence of AIS.2.Changes in inflammatory factor levels are related to the onset of AIS.The heavier the patient's condition,the higher the levels of TNF-?,NLR and PLR.These three indicators can be used to determine the severity of the patient's early condition.