| ObjectiveThe purpose of this study was to investigated the relationship between serum Fibroblast Growth Factor 21 levels and the severity and 90-day prognosis of Large Artery Atherosclerosis cerebral infarction by measuring the serum levels of FGF21 in patients with LAA cerebral infarction.MethodNinety-six patients with LAA cerebral infarction who were hospitalized in the Department of Neurology of Subei people’s Hospital from January 2020 to November2020 were collected as the case group,and 47 healthy control(HC)patients who were screened for stroke in the community during the same period were collected as the control group.The National Institutes of Health Scale was administered to the patients on the day of admission.The levels of FGF21 in the fasting serum on the day after admission and in the fasting serum on the morning of the examination day in the HC group were measured by ELISA.The differences in clinical data and serum FGF21 levels between the LAA and HC groups were compared by univariate analysis;patients in the LAA group were divided into subgroups based on NIHSS score and infarct volume,and the differences in serum FGF21 levels between the subgroups were compared;the patients’prognosis was assessed according to the modified Rankin Scale(m RS).Patients were divided into good prognosis group(m RS≤2)and poor prognosis group(m RS>2)according to m RS score,and the differences in clinical data and serum FGF21 content between the two groups were compared by univariate analysis.The prognostic value of serum FGF21 level on patients with LAA cerebral infarction was assessed by combining with ROC curve.Result1.A total of 143 cases were included in this study,including 96 cases in the LAA cerebral infarction group and 47 cases in the HC group.The differences between the two groups in terms of sex ratio,mean age and total cholesterol and triglycerides were not statistically significant in the univariate comparison(P>0.05).The differences among LDL,HDL,and serum FGF21 contents between the two groups were statistically significant(P<0.05);multi-factor logistic regression analysis showed that the differences among HDL,LDL,and serum FGF21 between the two groups were statistically significant(P<0.05);the LDL content in the LAA cerebral infarction group was higher than that in the HC group,and the HDL content was lower than that in the HC group.The serum FGF21 level was 57.41±4.84 pg/ml in LAA cerebral infarction patients and 45.11±6.21 pg/ml in HC group,which was significantly higher in LAA group than HC group,and the difference was statistically significant(P<0.05).2.When subgroups of LAA cerebral infarction groups were divided and compared,serum FGF21 levels were higher in the Non-mild stroke group(NIHSS>3points)than in the mild stroke group(NIHSS≤3 points),and serum FGF21 levels were higher in the infarct volume≥5 cm~3group than in the infarct volume<5 cm~3group,and all differences were statistically significant(P<0.05).Sperman correlation analysis was used to compare the correlation between serum FGF21 level and NIHSS score and infarct volume,and the results showed that serum FGF21 correlated with NIHSS score and infarct volume(r=0.307,P<0.05;r=0.316,P<0.05).3.Patients with LAA cerebral infarction were grouped according to the 90-day m RS score,of which 61 were in the good prognosis group and 35 were in the poor prognosis group;no significant differences were found between the two groups in terms of gender,age and past medical history,and the differences between the two groups in total cholesterol,uric acid,triglycerides,glycated hemoglobin,high-density lipoprotein and low-density lipoprotein were not statistically significant(P>0.05);in the poor prognosis group Serum FGF21 levels were significantly higher in the poor prognosis group than in the good prognosis group(59.46±4.39 pg/ml vs 55.61±4.67pg/ml),with statistically significant differences(P<0.05);mean age was higher in the poor prognosis group(P=0.011),and fasting glucose and D-dimer were higher than in the good prognosis group(P=0.043,P=0.015).NIHSS score and infarct volume were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05);multi-factor logistic regression analysis suggested that high serum FGF21level was an independent correlate of prognosis in LAA-type cerebral infarction.The results showed that the area under the ROC curve was 0.726(P<0.05,95%CI0.625-0.812),the maximum Yordon index was 0.383,the best cut-off value was 58.16pg/ml,the sensitivity was 62.9%,and the specificity was 75.4%..When the serum FGF21 concentration is greater than 58.16 pg/ml,patients with LAA cerebral infarction are more likely to have a poor prognosis.Conclusion1.Serum FGF21 levels were significantly higher in patients with LAA cerebral infarction than in healthy controls.2.Serum FGF21 expression level was related to the severity of disease and infarct volume in LAA cerebral infarction patients.3.Serum FGF21 may be one of the predictors of prognosis in patients with LAA cerebral infarction. |
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