Abstract
Ninjurin-1 is a novel adhesion molecule which is involved in many inflammatory diseases. Functional blockage of Ninjurin-1 has exerted an atheroprotective effect. The aim of the study is to explore the association between serum Ninjurin-1 and the risk of large artery atherosclerotic acute ischemic stroke. From August 2020 through December 2021, patients with large artery atherosclerotic acute ischemic stroke (LAA-AIS) admitted to the First Hospital Affiliated to Soochow University, and age- and sex-matched controls free of ischemic stroke were recruited. Serum Ninj1 was measured with an enzyme-linked immunosorbent assay. Multivariable logistic regression models were used to calculate the odds ratios and 95% confidence intervals of LAA-AIS associated with serum Ninj1 levels, and receiver operating characteristic (ROC) curves were performed to assess the improvement value of Ninj1 for the prediction of LAA-AIS after adding Ninj1 to established risk factors. Of the 110 patients and 110 age- and sex-matched controls free of ischemic stroke enrolled, serum Ninj1 levels in LAA-AIS patients were significantly higher than that in control group (142.70 ng/ml [IQR: 110.41–163.44] vs 101.62 ng/ml [IQR: 86.63–120.86], p < 0.001). In multivariable analysis, Ninj1 levels were expressed as continuous variable and ordinal variable (tertiles), and it turned out that Ninj1 levels were positively associated with increased risk of LAA-AIS, especially in tertile3 compared with tertile1 (adjusted OR = 12.567, 95%CI: 5.148–30.678, p < 0.001), and the adjusted odds OR per 10 ng/ml increment was 1.541, 95%CI: 1.348–1.763, p < 0.001. Furthermore, adding Ninj1 to a multivariate logistic model including conventional risk factors associated LAA-AIS improved the area under ROC curves from 0.787 to 0.874. Elevated circulating levels of Ninj1 were associated with increased risk of LAA-AIS, indicating that serum Ninj1 may act as a predictor independent of established conventional risk factors.
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Data Availability
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- AIS:
-
Acute ischemic stroke
- LAA-AIS:
-
Large artery atherosclerotic acute ischemic stroke
- ROC:
-
Receiver operating characteristic curve
- ASCVD:
-
Atherosclerotic cardiovascular disease
- CAD:
-
Coronary artery disease
- TOAST criteria:
-
Trial of Org 10172 in Acute Stroke Treatment criteria
- AUC:
-
Area under receiver operating characteristic curve
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Funding
This study was supported by National Natural Science Foundation of China (82071300), Suzhou Science and Technology Development Plan (SYSD2020073), The Stroke Team of Professor Fang Qi from the First Affiliated Hospital of Soochow University (SZYQTD202106); a follow-up study of cognitive impairment combined with depression in stroke patients (SYSD2020073); Suzhou Industrial Park Jinji Lake Health Talents (202110).
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QF conceived and designed the research. ND analyzed the data and drafted the manuscript. ND, XW, TH, XS, XG, HW, LY, and HZ collected the data and performed the research. All authors reviewed and edited the manuscript and approved the final version of the manuscript.
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The protocol of the study conforms to the ethical guidelines mentioned in the Declaration of Helsinki and was approved by the Ethics Committee of the First Hospital Affiliated to Soochow University (No. 2021–07-01). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
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Dong, N., Wu, X., Hong, T. et al. Elevated Serum Ninjurin-1 Is Associated with a High Risk of Large Artery Atherosclerotic Acute Ischemic Stroke. Transl. Stroke Res. 14, 465–471 (2023). https://doi.org/10.1007/s12975-022-01077-6
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DOI: https://doi.org/10.1007/s12975-022-01077-6