Clinical Relevance Of Serum CIRBP Levels In Patients With Atherosclerotic Ischemic Stroke

Objective: To find out the relationship between serum CIRBP levels and carotid atherosclerosis in patients with large artery atherosclerotic ischemic stroke at various time periods,and to analyze the influence of CIRBP levels on the severity and shortterm prognosis of patients with ischemic stroke.Methods: A total of 148 patients who were hospitalized in the Department of Neurology of the Second Hospital of Lanzhou University between May 2021 and October 2022 and were finally diagnosed with atherosclerotic ischemic stroke were enrolled in the study.Fasting blood specimens were collected,and the supernatant was centrifuged and frozen for storage.The baseline data of all included patients were recorded,including age,gender,ethnicity,height,weight,place of residence,systolic blood pressure at admission,diastolic blood pressure,history of smoking and alcohol consumption,previous underlying diseases such as hypertension,diabetes,hyperlipidemia,coronary heart disease,and whether the patient has been taking medication for a long time.The patients were also collected with routine blood and biochemical tests,carotid vascular ultrasound,transcranial Doppler ultrasound and cranial MRI data,and then serum CIRBP levels were measured by enzyme-linked immunosorbent assay in the enrolled patients.They were divided into low CIRBP expression group and high CIRBP expression group according to the median serum CIRBP levels to investigate the effect of serum CIRBP levels on large artery atherosclerotic ischemic,and a 90-day post-onset follow-up was performed to assess the short-term prognosis.Results: The median serum CIRBP levels measured in this study were 279.94 pg/ml,the 25 th percentile was 235.46 pg/ml,and the 75 th percentile was 318.79 pg/ml,and the enrolment patients were categorized into CIRBP low expression group and CIRBP high expression group according to the measured median levels,and it was found that patients with a previous history of coronary heart disease in the CIRBP high expression group(P = 0.012)were more frequent in the CIRBP high expression group.In addition,the levels of BMI(P = 0.024),TC(P = 0.013),LDL-C(P = 0.034)and RC(P = 0.029)were higher in the CIRBP high expression group in comparison with the CIRBP low expression group;63 patients(91.3%)had a favorable prognosis at 90 days and 6 patients(8.7%)had a poor prognosis in the CIRBP low expression group;57 cases(79.2%)had a favorable prognosis at 90 days and 15 cases(20.8%)had a poorer prognosis in the group with high CIRBP expression.The time to infarction in the enrolled patients was recorded as 3(2～5)in the low CIRBP expression group and 3(1～3)in the high CIRBP expression group(P=0.047);The correlation analysis revealed no significantly correlation between CIRBP and the degree of carotid atherosclerosis,and then the correlation analysis was made between the common risk factor indicators of atherosclerosis and CIRBP levels,and the results showed that a positively correlation between CIRBP level and BMI(r = 0.220,P<0.01),TC(r = 0.262,P < 0.01),LDL-C(r = 0.217,P < 0.01)and RC(r = 0.197,P <0.05);for the above factors that were positively correlated with CIRBP,further multiple linear regression analysis was executed,and the regression model suggested that BMI,history of coronary heart disease,LDL-C and RC had a greater influence on serum CIRBP level,among which,the influence of BMI on serum CIRBP level was relatively greater.Secondly,CIRBP levels were tightly linked to the severity of disease in patients with large atherosclerotic ischemic stroke in two ways: CIRBP levels were higher in the moderate to severe neurological deficits(NIHSS >3)than in the mild neurological deficits group(NIHSS ≤3)(P < 0.01);CIRBP levels were higher in the larger infarct volume group(V ≥5 cm3)than in the infarct volume(V <5 cm3)(P < 0.01);patients in the poor prognosis group(m RS score > 2)had higher admission NIHSS score(P < 0.01),infarct volume(P < 0.01)and serum CIRBP level(P < 0.01)than those in the good prognosis group(m RS score ≤ 2);correlation analysis indicated that CIRBP level was positively correlated with NIHSS score,infarct volume and m RS score were positively correlated(r=0.304,P<0.01;r=0.240,P<0.01;r=0.244,P<0.01,respectively).Conclusion: The expression of serum CIRBP in patients with large-artery atherosclerotic ischemic stroke fluctuated with time of onset,with maximum expression within 3 days of stroke onset,followed by a subsequent gradual decrease;serum CIRBP levels were not significantly related to the degree of carotid atherosclerosis,but were closely related to several common risk factors for atherosclerosis;serum CIRBP levels are positively correlated with the severity of atherosclerotic ischemic stroke disease,and higher levels of CIRBP have a close influence on the development and progression of the disease.