Correlation between serum LRG1 level and cognitive impairment and recurrence in patients with acute ischemic stroke

doi:10.3969/j.issn.1673-8640.2024.05.005

Abstract

Abstract:

Objective To investigate the role of leucine-rich alpha-2 glycoprotein-1（LRG1） level in cognitive impairment and its relationship with recurrence in patients with acute ischemic stroke（AIS）. Methods A total of 125 patients with AIS admitted to Nanyang Central Hospital from January 2020 to October 2021 were enrolled，the clinical data and the results of homocysteine（Hcy） and blood lipid determinations for all the patients were collected，and serum LRG1 levels were determined. The research subjects were classified into cognitive impairment group [Montreal Cognitive Assessment（MoCA）<26] and non-cognitive impairment group（MoCA≥26） according to MoCA scale. They were classified into recurrence group and non-recurrence group based on the stroke recurrence situation after 6 months. Pearson or Spearman correlation was performed to analyze the correlation between serum LRG1 level and other indicators. Multivariate Logistic regression was performed to analyze the influencing factors of cognitive impairment in AIS patients. The efficacy of various indicators in predicting cognitive impairment and stroke recurrence in AIS patients was evaluated by receiver operating characteristic（ROC） curve. Results Total cholesterol（TC） level and the proportion of hyperlipidemia in cognitive impairment group were higher than those in non-cognitive impairment group（P<0.05），while the levels of LRG1 and high-density lipoprotein cholesterol（HDL-C） were lower than those in non-cognitive impairment group（P<0.001）. There was no statistical significance in the other clinical data between the 2 groups（P>0.05）. Serum LRG1 levels in AIS patients with cognitive impairment were positively correlated with HDL-C（r=0.497，P<0.05） and were negatively correlated with hyperlipidemia and TC（r values were -0.492 and -0.486，P<0.05）. The decrease in LRG1 and HDL-C levels was a risk factor for cognitive impairment in AIS patients [odds ratios（OR） were 0.845 and 0.876，95% confidence intervals（CI） were 0.748-0.954 and 0.793-0.968，respectively，P<0.05]. The areas under curves（AUC） for single and combined determinations of serum LRG1 and HDL-C to determine cognitive impairment in AIS patients were 0.840，0.670 and 0.851，respectively. Serum LRG1 and HDL-C levels in recurrence group were lower than those in non-recurrence group（P<0.05），and TC levels and the proportion of hyperlipidemia were higher than those in non-recurrence group（P<0.05）. The AUC for single and combined determinations of serum LRG1，HDL-C and TC to determine stroke recurrence in AIS patients were 0.781，0.696，0.806 and 0.899，respectively. Conclusions Serum LRG1 level is related to cognitive impairment and recurrence in patients with AIS，and it may serve as one of the predictive indicators for cognitive impairment and stroke recurrence after AIS.

Key words: Leucine-rich alpha-2 glycoprotein-1, Acute ischemic stroke, Cognitive impairment, Stroke recurrence

CLC Number:

R446.1

GU Liangliang, WANG Jianfeng, QIAO Xin, ZHANG Baochao, FU Guohui. Correlation between serum LRG1 level and cognitive impairment and recurrence in patients with acute ischemic stroke[J]. Laboratory Medicine, 2024, 39(5): 443-448.

Figures/Tables 7

References 19

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组别	例数	年龄/岁	性别		BMI/（kg·m^-2）	发病至入院时间/h		收缩压/kPa		舒张压/kPa		吸烟史/ [例（%）]
组别	例数	年龄/岁	男/例	女/例	BMI/（kg·m^-2）	发病至入院时间/h		收缩压/kPa		舒张压/kPa		吸烟史/ [例（%）]
无认知障碍组	89	65.44±8.23	53	36	23.02±1.58	6.74±2.33		18.79±2.24		11.56±1.16		46（51.69）
认知障碍组	36	65.78±9.02	22	14	23.25±1.64	6.82±2.49		19.12±2.69		11.71±1.11		18（50.00）
统计值		0.203	0.026		0.729	0.170		0.320		0.663		0.029
P值		0.839	0.872		0.467	0.865		0.750		0.509		0.864
组别	饮酒史/ 例	高血压史/ 例	糖尿病史/ 例		高血脂/ 例	LDL-C/ （mmol·L^-1）		HDL-C/ （mmol·L^-1）		TG/ （mmol·L^-1）		TC/ （mmol·L^-1）
无认知障碍组	22	43	22		19	2.51±0.46		1.06±0.12		1.85±0.39		4.19±0.92
认知障碍组	9	22	10		16	2.56±0.49		0.90±0.11		1.87±0.34		4.61±0.76
统计值	0.001	1.682	0.126		6.782	0.540		6.909		0.269		2.423
P值	0.974	0.195	0.723		0.009	0.590		<0.001		0.788		0.017
组别	Hcy/ （μmol·L^-1）		LRG1/ （μg·mL^-1）		病灶部位			病灶大小		发病半球		脑白质疏松/ 例
组别	Hcy/ （μmol·L^-1）		LRG1/ （μg·mL^-1）		基底节/例		非基底节/例	小病灶/例	大病灶/例	左侧/例	右侧/例	脑白质疏松/ 例
无认知障碍组	16.74±4.28		290.24±69.74		49		40	66	23	42	47	26
认知障碍组	18.25±4.35		214.39±56.83		22		14	21	15	15	21	12
统计值	1.778		5.790		0.383			3.033		0.315		0.206
P值	0.078		<0.001		0.536			0.082		0.574		0.650

组别	例数	年龄/岁	性别		BMI/（kg·m^-2）	发病至入院时间/h		收缩压/kPa		舒张压/kPa		吸烟史/ [例（%）]
组别	例数	年龄/岁	男/例	女/例	BMI/（kg·m^-2）	发病至入院时间/h		收缩压/kPa		舒张压/kPa		吸烟史/ [例（%）]
无认知障碍组	89	65.44±8.23	53	36	23.02±1.58	6.74±2.33		18.79±2.24		11.56±1.16		46（51.69）
认知障碍组	36	65.78±9.02	22	14	23.25±1.64	6.82±2.49		19.12±2.69		11.71±1.11		18（50.00）
统计值		0.203	0.026		0.729	0.170		0.320		0.663		0.029
P值		0.839	0.872		0.467	0.865		0.750		0.509		0.864
组别	饮酒史/ 例	高血压史/ 例	糖尿病史/ 例		高血脂/ 例	LDL-C/ （mmol·L^-1）		HDL-C/ （mmol·L^-1）		TG/ （mmol·L^-1）		TC/ （mmol·L^-1）
无认知障碍组	22	43	22		19	2.51±0.46		1.06±0.12		1.85±0.39		4.19±0.92
认知障碍组	9	22	10		16	2.56±0.49		0.90±0.11		1.87±0.34		4.61±0.76
统计值	0.001	1.682	0.126		6.782	0.540		6.909		0.269		2.423
P值	0.974	0.195	0.723		0.009	0.590		<0.001		0.788		0.017
组别	Hcy/ （μmol·L^-1）		LRG1/ （μg·mL^-1）		病灶部位			病灶大小		发病半球		脑白质疏松/ 例
组别	Hcy/ （μmol·L^-1）		LRG1/ （μg·mL^-1）		基底节/例		非基底节/例	小病灶/例	大病灶/例	左侧/例	右侧/例	脑白质疏松/ 例
无认知障碍组	16.74±4.28		290.24±69.74		49		40	66	23	42	47	26
认知障碍组	18.25±4.35		214.39±56.83		22		14	21	15	15	21	12
统计值	1.778		5.790		0.383			3.033		0.315		0.206
P值	0.078		<0.001		0.536			0.082		0.574		0.650

项目	β值	标准误	Wald值	OR值（95%CI）	P值
LRG1	-0.168	0.062	7.379	0.845（0.748~0.954）	0.007
高血脂	0.044	0.128	0.118	1.045（0.813~1.343）	0.731
HDL-C	-0.132	0.051	6.739	0.876（0.793~0.968）	0.009
TC	0.097	0.086	1.275	1.102（0.931~1.304）	0.259

项目	β值	标准误	Wald值	OR值（95%CI）	P值
LRG1	-0.168	0.062	7.379	0.845（0.748~0.954）	0.007
高血脂	0.044	0.128	0.118	1.045（0.813~1.343）	0.731
HDL-C	-0.132	0.051	6.739	0.876（0.793~0.968）	0.009
TC	0.097	0.086	1.275	1.102（0.931~1.304）	0.259

项目	AUC（95%CI）	最佳临界值	敏感性/%	特异性/%	Youden指数
LRG1	0.840（0.771~0.909）	230.08 μg·mL^-1	92.8	66.1	0.589
HDL-C	0.670（0.572~0.767）	0.97 mmol·L^-1	56.4	74.3	0.307
联合检测	0.851（0.784~0.918）	0.925	92.3	60.8	0.531