Relationship Between Serum Apelin-13，Gal-3，sLOX-1 and Early Neurological Deterioration in Elderly Patients with Acute Ischemic Stroke and Their Predictive Significance

Zhiming YAO; Biwen ZENG; Guoming WANG

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Zhiming YAO, Biwen ZENG, Guoming WANG. Relationship Between Serum Apelin-13，Gal-3，sLOX-1 and Early Neurological Deterioration in Elderly Patients with Acute Ischemic Stroke and Their Predictive Significance[J]. Journal of Kunming Medical University.

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Relationship Between Serum Apelin-13，Gal-3，sLOX-1 and Early Neurological Deterioration in Elderly Patients with Acute Ischemic Stroke and Their Predictive Significance

1.
Department of General Practice，Guangyuan Mental Health Center /Guangyuan Third People’s Hospital
2.
Department of Geriatrics，Guangyuan Sichuan 62800
3.
Department of Traditional Chinese Orthopedics，Lizhou District Traditional Chinese Medicine Hospital，Guangyuan Sichuan 628000，China

Abstract

Abstract

Objective To investigate the relationship between serum apelin-13 （a lonely G protein-coupled receptor ligand-13）, galectin-3 （Gal-3）, soluble lectin-like oxidized low-density lipoprotein receptor-1 （sLOX-1） and early neurological deterioration （END） in elderly patients with acute ischemic stroke （AIS） and to evaluate their predictive significance. Methods A total of 196 elderly AIS patients admitted to Guangyuan Mental Health Center / Guangyuan Third People’s Hospital and Guangyuan Lizhou District Traditional Chinese Medicine Hospital from January 2022 to May 2024 were enrolled. All patients received targeted treatment based on their condition.On the 7 th day of admission, the occurrence of END was evaluated, and patients were divided into non-END group （n = 152） and END group （n = 44）. Baseline data and serum levels of Apelin-13, Gal-3 and sLOX-1 were compared between the two groups. The relationship between serum Apelin-13, Gal-3, sLOX-1 and the National Institute of Health Stroke Scale （NIHSS） score was analyzed. The effects of serum Apelin-13, Gal-3 and sLOX-1 on END were analyzed, and their predictive value for END was evaluated. Results The volume of cerebral infarction and NIHSS score in the END group were significantly higher than those in the non-END group （P < 0.05）. Serum Apelin-13 level in the END group was significantly lower, while serum Gal-3 and sLOX-1 levels were significantly higher than those in the non-END group （P < 0.05）. Serum Apelin-13 level was negatively correlated with NIHSS score, while serum Gal-3 and sLOX-1 levels were positively correlated with NIHSS score （P < 0.05）. Logistic regression analysis showed that serum Apelin-13, Gal-3 and sLOX-1 were independent influencing factors for END in AIS patients after adjusting for cerebral infarction volume and NIHSS score （P < 0.05）. The AUC for predicting END in AIS patients were 0.763 （95%CI: 0.677-0.835） for apelin-13, 0.823 （95%CI: 0.743-0.886）for Gal-3, and 0.838 （95%CI: 0.760-0.899） for sLOX-1, with sensitivities of 84.09%, 84.09% and 86.36%, and the specificities of 65.79%, 76.32% and 75.66%, respectively. The AUC of the combined prediction of the three markers was 0.944 （95%CI: 0.887-0.978）, which was significantly higher than that of each individual marker （P < 0.05）, with a sensitivity of 86.36% and a specificity of 91.45%. Ten-fold cross validation showed that the average AUC of the combined prediction of serum apelin-13, Gal-3 and sLOX-1 was 0.936 （95%CI: 0.875-0.969）, which was close to the original model result, indicating that the model was stable; The calibration curve showed that the prediction model of END in AIS patients was highly consistent with the probability of clinical observation （Hosmer lemeshow test χ² = 5.712, P = 0.493）; The DCA curve showed that the model had a significant and stable clinical net benefit across a wide range of threshold probabilities of 30% -80%. Conclusion Serum Apelin-13, Gal-3 and sLOX-1 are significantly correlated with END in elderly AIS patients, which can be used as independent predictors, and the combined predictive value is reliable.

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References(30)

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