Abstract
Aims This study aims to examine the associations between paraoxonase 1 (PON)1 status and acute ischemic stroke (AIS) and consequent disabilities.
Methods This study recruited 122 patients with AIS and 40 healthy controls and assessed the Q192R gene variants, arylesterase (AREase) and chloromethyl phenylacetate (CMPAase) activities, and high-density lipoprotein cholesterol (HDL) in baseline conditions. AREase and CMPAase were measured 3 months later. The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin score (mRS) were assessed at baseline and 3 and 6 months later.
Results Reduced CMPAase and increased AREase activities are significantly associated with AIS and mRS and NIHSS scores (baseline and 3 and 6 months later). The best predictor of AIS/disabilities was a decrease in the z-unit-based composite zCMPAase-zAREase score. Serum high density lipoprotein cholsterol (HDL) was significantly correlated with CMPAase, but not AREase, activity and a lowered zCMPAase+zHDL score was the second best predictor of AIS/disabilities. Regression analysis showed that 34.7% of the variance in baseline NIHSS was explained by zCMPAase-zAREase and zCMPAase+zHDL composites, HDL, and hypertension. Neural network analysis showed that stroke was differentiated from controls with an area under the ROC curve of 0.975 using both new composite scores, PON1 status, hypertension, dyslipidemia, previous stroke as body mass index. The PON1 Q192R genotype has many significant direct and mediated effects on AIS/disabilities, however, its overall effect was not significant.
Discussion PON1 status and the CMPAase-HDL complex play key roles in AIS and its disabilities at baseline and 3 and 6 months later.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
This research was supported by the Rachadabhisek Research Grant, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. The sponsor had no role in the data or manuscript preparation.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Institutional Review Board of the Faculty of Medicine, Chulalongkorn University/IRB 006/62
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Data Availability
All data produced in the present study are available upon reasonable request to the authors