Study on the correlation of serum levels of LP(a), LDL-C, Hcy and Cys C with acute cerebral infarction and their diagnostic value

ObjectiveTo investigate the correlation of serum levels of lipoprotein aLP(a), low-density lipoprotein cholesterol (LDL-C), homocysteine(Hcy) and cystatin C(Cys C) with acute cerebral infarction(ACI), and their diagnostic value.

MethodsThe neurological function scoring in 300 ACI patients(case group) were investigated using NHISS scale, and 70 medical examinees were set as the control group during the same period.The serum levels of glucose(GLU), cholesterol(CHOL), high-density lipoprotein cholesterol(HDL-C), triacylagly cerol(TG), LP(a), LDL-C, Hcy and Cys C were compared between two groups.According to NHISS score, the ACI patients were divided into the mild group(n=173), moderate group(n=89) and severe group(n=38), and the serum levels of LP(a), LDL-C, Hcy and Cys C among three groups were compared.The multi-factor model was established using multivariate logistic regression, and the ROC curve was drawn to evaluate the diagnostic value of alone and combination of LP(a), LDL-C, Hcy and Cys C for ACI.

ResultsThe serum levels of GLU, CHOL, HDL-C, LP(a), LDL, Hcy and Cys C in case group were higher than those in control group(P < 0.05 to P < 0.01), and the difference of the level of TG between two groups was not statistically significant(P>0.05).The serum levels of LDL-C and Hcy in ACI mild group, moderate group and severe group gradually increased(P < 0.05);and the differences of the levels of LDL-C and Hcy among three groups was not statistically significant(P>0.05).The results of ROC analysis showed that the Hcy alone in the diagnosis of ACI had high accuracy(the area under ROC curve, sensitivity, specificity and Youden index were 0.799, 81.00%, 88.53% and 69.53%, respectively).The accuracy of combination of serum LP(a), LDL-C, Hcy and Cys C in the diagnosis of ACI was the highest(the area under ROC curve, sensitivity, specificity, Youden index were 0.841, 97.14%; 90.63%, 87.77% and 0.80, respectively).

ConclusionsThe serum levels of LP(a), LDL-C, Hcy and Cys C are related to the occurrence and severity of ACI, and the LDL-C and Hcy are associated with the severity of ACI.The combined detection of LDL-C, Hcy and Cys C has a higher sensitivity and specificity for the diagnosis of ACI, which may become an early predictor biological indicating of ACI occurrence.