Correlation Study Of Serum SCD40L,Lipids,Hcy And Carotid Atherosclerosis Plaque

Objective Through observing the changes of serum Hcy, serum lipids and sCD40L levels in patients with acute cerebral infarction, to investigate the relationships among them and stability of carotid atherosclerosis plaque, and to provide references for prevention and treatment of acute ischemic stroke.Methods In all the 76 subjects, including 56 patients with acute anterior circulation cerebral infarction and 20 subjects without acute ischemic cerebrovascular diseases, Serum Hcy (with fluorescence polarization immunoassay), serum lipids, FBG and sCD40L [with commercially available ELISA kits (Adlitteram diagnostic laboratories, American)] levels were measuered, Plaque echogenicity and morphology were evaluated bilaterally by carotid ultrasonography. Ischemic infarctions in brain were evaluated by CT/MRI, and stroke severity was measured at the time of admission with the National Institutes of Health Stroke Scale.Results①Serum Hcy and sCD40L levels were significantly higher in the patients [Hcy: 25.11±17.25μmol/L, sCD40L:3.82±1.04ng/mL] than those in controls [Hcy:16.11±11.96μmol/L, sCD40L:3.24±0.68ng/mL] (P<0.05), and ApoAl level was significantly lower in the patients [ApoA1:1.14±0.27mmol/L] than that in controls [ApoAl:1.40±0.29mmol/L].②Multiple regression models of sCD40L vs. ischemic infarction-related risk factors were adjusted for age,sex,smoking,drinking,Hcy,TG,TC,LDL-C,HDL-C,ApoA1,ApoB100,LP(a) and FBG. there was a positive correlation between the serum levels of sCD40L and Hcy(r=0.479, P< 0.01), multiple linear regression:y=0.0288x+3.0167, regression coefficient 95% CI:(0.017,0.041), coefficient of determination:R2=0.229. however, serum lipid and FBG levels were not significantly correlated with the level of serum sCD40L.③Among patients there was a significant difference in serum sCD40L levels[(3.97±1.06) ng/mL VS (3.37±0.83) ng/mL] between group A (patients with serum Hcy(?)16μmol/L) and group B (patients with serum Hcy<16μmol/L). Hypoechoic or isoechoic plaques in group A consisted higher proportions than that in group B, and there were significant difference in the proportion of hypoechoic plaques between group A and group B [13.4% VS 4%] (P<0.05).Conclusion Elevated Hcy levels may be related to the presence of inflammation of carotid plaque in which sCD40L play an important role in plaque's destabilization and development of ischemic stroke.