|
|
血清糖化白蛋白、同型半胱氨酸水平与急性脑梗死严重程度的相关性分析
|
Abstract:
目的：探讨急性脑梗死(ACI)患者血清中糖化白蛋白(GA)、同型半胱氨酸(Hcy)水平在脑梗死中的影响。方法：选取来我院神经内科就诊的首次发作ACI患者195例，以NHISS评分为分组依据，分为正常或近乎正常组63例(NIHSS评分0~1分)、轻度卒中/小卒中83例(NIHSS评分2~4分)、中–重度组49例(NIHSS评分 ≥ 5分)。比较不同NIHSS评分组患者入院时血清GA、Hcy水平，评估GA、Hcy水平两者之间关系及两者与NIHSS评分之间关系。结果：GA水平与Hcy水平之间存在明显正相关(r = 0.319, P < 0.05)；NIHSS评分与GA、Hcy水平之间经Spearman相关性分析结果显示，NIHSS评分与GA之间存在明显的正相关(r = 0.438, P < 0.05)，NIHSS评分与Hcy之间存在明显的正相关(r = 0.377, P < 0.05)。有序Logistic回归分析GA、Hcy与ACI患者神经功能缺损有显著关联性，而且还是独立危险因素。结论：血清GA水平越高，Hcy水平越高。血清GA、Hcy水平是ACI患者神经功能缺损的危险因素。
Objective: To investigate the effect of glycated albumin (GA) and homocysteine (Hcy) levels in cere-bral infarction in patients with acute cerebral infarction (ACI). Methods: 195 patients with first on-set ACI in our hospital were divided into 63 normal or near-normal group (NIHSS score 0~1), 83 mild stroke/minor stroke (NIHSS score 2~4), and 49 moderate-severe group (NIHSS score 5). Com-pared the serum GA and Hcy levels at admission in different NIHSS score groups, and evaluated the relationship between GA and Hcy levels and the relationship between both and NIHSS score. Results showed clear positive correlation between GA level and Hcy level (r = 0.319, P < 0.05); Spearman correlation between NIHSS score and GA and Hcy level showed significant positive correlation be-tween NIHSS score and GA (r = 0.438, P < 0.05) and significant positive correlation between NIHSS score and Hcy (r = 0.377, P < 0.05). Original Logistic regression analysis GA and Hcy showed signifi-cant associations with neurological deficit in ACI patients and were independent risk factors. Con-clusion: The higher the serum GA level, the higher the Hcy. Serum GA and Hcy levels are risk factors for neurological deficit in ACI patients.
| [1] | Lozano, R., Naghavi, M., Foreman, K., et al. (2012) Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: A Systematic Analysis for the Global Burden of Disease Study 2010. The Lancet, 380, 2095-2128. https://doi.org/10.1016/S0140-6736(12)61728-0 |
| [2] | Soerjomataram, I., Lortet-Tieulent, J., Parkin, D.M., et al. (2012) Global Burden of Cancer in 2008: A Systematic Analysis of Disability-Adjusted Life-Years in 12 World Regions. The Lancet, 380, 1840-1850.
https://doi.org/10.1016/S0140-6736(12)60919-2 |
| [3] | Meiklejohn, D.J., Vickers, M.A., Dijkhuisen, R., et al. (2001) Plasma Homocysteine Concentrations in the Acute and Convalescent Periods of Atherothrombotic Stroke. Stroke, 32, 57-62. https://doi.org/10.1161/01.STR.32.1.57 |
| [4] | Alasheev, A.M. andreev, A.Y., Gonysheva, Y.V., et al. (2016) A Comparison of Remote and Bedside Assessment of the NIH Stroke Scale in Acute Stroke Patients. Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova, 116, 23-27.
https://doi.org/10.17116/jnevro20161163223-27 |
| [5] | 彭斌, 刘鸣, 崔丽英. 与时俱进的新指南——《中国急性缺血性脑卒中诊治指南 2018》解读[J]. 中华神经科杂志, 2018, 51(9): 657-659. |
| [6] | Bao, Y. and Zhu, D. (2022) Clinical Application Guidelines for Blood Glucose Monitoring in China (2022 Edition). Diabetes/Metabolism Research and Reviews, 38, e3581. https://doi.org/10.1002/dmrr.3581 |
| [7] | Liu, X., Wu, N. and Al-Mureish, A. (2021) A Re-view on Research Progress in the Application of Glycosylated Hemoglobin and Glycated Albumin in the Screening and Monitoring of Gestational Diabetes. International Journal of General Medicine, 14, 1155-1165. https://doi.org/10.2147/IJGM.S296316 |
| [8] | 亓海萍, 吕卫华, 武琳. 糖化血红蛋白、同型半胱氨酸及尿微量白蛋白与2型糖尿病合并肾脏微血管病变的关系研究[J]. 中国实验诊断学, 2015(11): 1840-1843. |
| [9] | Shen, Y., Pu, L.J., Lu, L., et al. (2012) Glycated Albumin Is Superior to Hemoglobin A1c for Evaluating the Presence and Severity of Coronary Artery Disease in Type 2 Diabetic Patients. Cardiology, 123, 84-90.
https://doi.org/10.1159/000342055 |
| [10] | Lee, S.H., Jang, M.U., Kim, Y., et al. (2020) Effect of Prestroke Glycemic Variability Estimated Glycated Albumin on Stroke Severity and Infarct Volume in Diabetic Patients Presenting with Acute Ischemic Stroke. Frontiers in Endocrinology (Lausanne), 11, 230. https://doi.org/10.3389/fendo.2020.00230 |
| [11] | Kishikawa, H., Mine, S., Kawahara, C., et al. (2006) Glycated Al-bumin and Cross-Linking of CD44 Induce Scavenger Receptor Expression and Uptake of Oxidized LDL in Human Monocytes. Biochemical and Biophysical Research Communications, 339, 846-851. https://doi.org/10.1016/j.bbrc.2005.11.091 |
| [12] | Paradela-Dobarro, B., Bravo, S.B., Rozados-Luis, A., et al. (2019) Inflammatory Effects of in Vivo Glycated Albumin from Cardiovascular Patients. Biomedicine & Pharmacotherapy, 113, Article ID: 108763.
https://doi.org/10.1016/j.biopha.2019.108763 |
| [13] | Zendjabil, M. (2020) Glycated Albumin. Clinica Chimica Acta, 502, 240-244.
https://doi.org/10.1016/j.cca.2019.11.007 |
| [14] | Kim, K.J. and Lee, B.W. (2012) The Roles of Glycated Albumin as Intermediate Glycation Index and Pathogenic Protein. Diabetes & Metabolism Journal, 36, 98-107. https://doi.org/10.4093/dmj.2012.36.2.98 |
| [15] | Guieu, R., Ruf, J. and Mottola, G. (2022) Hyperhomocysteinemia and Cardiovascular Diseases. Annales de Biologie Clinique (Paris), 80, 7-14. https://doi.org/10.1684/abc.2021.1694 |
| [16] | McCully, K.S. (1969) Vascular Pathology of Homocysteinemia: Impli-cations for the Pathogenesis of Arteriosclerosis. The American Journal of Pathology, 56, 111-128. |
| [17] | 孙颖. 血清脂联素、同型半胱氨酸与细胞间黏附分子1在急性脑梗死患者中的表达及意义[J]. 山东医药, 2010, 50(33): 75-76. |
| [18] | Kamtchum-Tatuene, J., Saba, L., Heldner, M.R., et al. (2022) Interleukin-6 Predicts Carotid Plaque Severity, Vulnerability, and Progression. Circulation Research, 131, e22-e33. https://doi.org/10.1161/CIRCRESAHA.122.320877 |
| [19] | Yamagami, H., Kitagawa, K., Hoshi, T., et al. (2005) Associations of Serum IL-18 Levels with Carotid Intima-Media Thickness. Arteriosclerosis, Thrombosis, and Vascular Biology, 25, 1458-1462.
https://doi.org/10.1161/01.ATV.0000168417.52486.56 |
| [20] | Aso, Y., Okumura, K., Takebayashi, K., et al. (2003) Relationships of Plasma Interleukin-18 Concentrations to Hyperhomocysteinemia and Carotid Intimal-Media Wall Thickness in Patients with Type 2 Diabetes. Diabetes Care, 26, 2622-2627. https://doi.org/10.2337/diacare.26.9.2622 |
| [21] | Schnabel, R., Lackner, K.J., Rupprecht, H.J., et al. (2005) Glutathi-one Peroxidase-1 and Homocysteine for Cardiovascular Risk Prediction: Results from the AtheroGene Study. Journal of the American College of Cardiology, 45, 1631- 1637. https://doi.org/10.1016/j.jacc.2005.02.053 |
| [22] | 刘国荣, 徐永平, 陈伟彬. 血浆同型半胱氨酸与颈动脉粥样硬化的相关分析[J]. 中华老年心脑血管病杂志, 2020, 22(3): 285-287. |
| [23] | Mathai, M., Radford, S.E. and Holland, P. (2007) Progressive Glycosylation of Albumin and Its Effect on the Binding of Homocysteine May Be a Key Step in the Pathogenesis of Vascular Damage in Diabetes Mellitus. Med-ical Hypotheses, 69, 166-172. https://doi.org/10.1016/j.mehy.2006.10.050 |
| [24] | 冯小萌, 纪蒙. 糖化白蛋白对糖尿病合并急性脑梗死患者同型半胱氨酸水平的影响[J]. 中国现代医学杂志, 2017, 27(6): 110-114. |
