Characteristics and clinical significance of serum renalase in patients with acute ischemic stroke

doi:10.3969/j.issn.1674-8115.2023.01.004

Abstract

Abstract:

Objective ·To examine the level change of serum renalase in the patients with acute ischemic stroke (AIS), and analyze its role in evaluating disease. Methods ·A total of 118 AIS patients admitted to the Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from July 2020 to November 2021 were enrolled in the case group (AIS group). The patients were assessed for neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS), and were classified as mild and moderate-severe neurological deficits. Another 133 healthy people who participated in physical examination in the physical examination center of the hospital during the same period were selected as the control group. The serum renalase levels of the two groups were detected by ELISA. Spearman's rank correlation analysis was used to evaluate the correlation between the levels of serum renalase and gender, age, fasting blood glucose, blood lipids and NIHSS scores in the patient with AIS. The predictive value of renalase expression level in AIS diagnosis was analyzed by receiver operator characteristic (ROC) curve. The factors that were statistically significant in the results of the univariate Logistic regression analysis were included in the multivariate Logistic regression model. Results ·The level of serum renalase in the AIS group was 2 960.01 (1 557.99, 4 053.70) pg/mL, which was higher than 821.02 (391.29, 1 752.70) pg/mL in the control group, with a statistically significant difference (P=0.000). Spearman's rank correlation analysis showed that the levels of serum renalase in the patients with AIS were negatively correlated with the NIHSS scores (r=-0.216, P=0.019), positively correlated with the serum fasting glucose (r=0.200, P=0.030), and not significantly correlated with gender, age, low-density lipoprotein levels, total cholesterol levels, and the presence of hypertension, diabetes, or coronary heart disease. Serum renalase levels were higher in the AIS with mild neurological deficit patients than those in the moderate-severe deficit patients, and the difference was statistically significant (P=0.034). The ROC curve showed that the cut-off value of serum renalase level to diagnose AIS was 1 856.49 pg/mL, the area under the curve was 0.777±0.030 and its 95%CI was 0.718?0.836 (P=0.000). Multivariate Logistic regression analysis showed that elevated serum renalase level [>1 856.49 pg/mL, odds ratio (OR)=6.980, P=0.000], hypertension (OR=5.382, P=0.000), and diabetes (OR=2.453, P=0.040) were risk factors for AIS. Conclusion ·Serum renalase level is significantly elevated in AIS patients, and negatively correlated with NIHSS score. Serum renalase might be a potential biomarker for the auxiliary diagnosis and assessment of AIS, providing new ideas for the assessment of stroke disease progression and precise treatment.

Key words: renalase, acute ischemic stroke (AIS), biomarker, NIHSS score

CLC Number:

R743.3

JIANG Wenqun, HOU Pinpin, CHEN Yan, JIA Feng, ZHANG Xiaohua, GAO Li, HU Qin. Characteristics and clinical significance of serum renalase in patients with acute ischemic stroke[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(1): 29-35.

Figures/Tables 6

TrendMD

References 30

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Item	AIS group （n=118）	Control group （n=133）	t/χ²/Z value	P value
Male/n （%）	87 （73.7）	93 （70.0）	0.446	0.504
Age/year	66 （58， 70）	64 （53， 69）	-1.839	0.066
TC/（mmol·L^-1）	4.74±1.08	4.96±1.06	1.644	0.102
LDL/（mmol·L^-1）	3.06±0.86	3.13±0.67	0.636	0.526
FPG/（mmol·L^-1）	6.20 （5.27， 8.17）	5.24 （4.75， 5.91）	-5.250	0.000
Hypertension/n （%）	79 （67.0）	28 （21.1）	53.854	0.000
CHD/n （%）	10 （8.5）	1 （0.8）	8.899	0.003
Diabetes/n （%）	34 （28.8）	12 （9.0）	16.362	0.000

Item	AIS group （n=118）	Control group （n=133）	t/χ²/Z value	P value
Male/n （%）	87 （73.7）	93 （70.0）	0.446	0.504
Age/year	66 （58， 70）	64 （53， 69）	-1.839	0.066
TC/（mmol·L^-1）	4.74±1.08	4.96±1.06	1.644	0.102
LDL/（mmol·L^-1）	3.06±0.86	3.13±0.67	0.636	0.526
FPG/（mmol·L^-1）	6.20 （5.27， 8.17）	5.24 （4.75， 5.91）	-5.250	0.000
Hypertension/n （%）	79 （67.0）	28 （21.1）	53.854	0.000
CHD/n （%）	10 （8.5）	1 （0.8）	8.899	0.003
Diabetes/n （%）	34 （28.8）	12 （9.0）	16.362	0.000

Item	Serum renalase level
Item	r value	P value
Gender	0.049	0.601
Age	0.078	0.399
Hypertension	0.103	0.266
Diabetes	0.066	0.480
CHD	-0.060	0.520
FPG	0.200	0.030
LDL	0.024	0.800
TC	0.039	0.672
NIHSS score	-0.216	0.019

Item	Serum renalase level
Item	r value	P value
Gender	0.049	0.601
Age	0.078	0.399
Hypertension	0.103	0.266
Diabetes	0.066	0.480
CHD	-0.060	0.520
FPG	0.200	0.030
LDL	0.024	0.800
TC	0.039	0.672
NIHSS score	-0.216	0.019

Item	Univariate Logistic regression analysis		Multivariate Logistic regression analysis
Item	OR （95%CI）	P value	OR （95%CI）	P value
Age/year
≤40	1.000	‒	‒	‒
41‒50	1.750 （0.482， 6.351）	0.395	‒	‒
51‒60	1.789 （0.596， 5.373）	0.300	‒	‒
61‒70	2.619 （0.934， 7.343）	0.067	‒	‒
71‒80	1.826 （0.585， 5.698）	0.300	‒	‒
≥81	3.267 （0.733， 14.551）	0.120	‒	‒
Gender
Female	1.000	‒	‒	‒
Male	1.207 （0.695， 2.098）	0.504	‒	‒
Hypertension	7.596 （4.311， 13.385）	0.000	5.382 （2.825， 10.251）	0.000
Diabetes	4.081 （1.997， 8.339）	0.000	2.453 （1.041， 5.782）	0.040
CHD	12.222 （1.540， 96.985）	0.018	4.901 （0.563， 42.651）	0.150
High level renalase（>1 856.49 pg·mL^-1）	8.504 （4.807， 15.045）	0.000	6.980 （3.707， 13.141）	0.000