Serum calcium, albumin, globulin and matrix metalloproteinase-9 levels in acute cerebral infarction patients

Zhong, Tingting; Gang, Wang; Wang, Xiaoqin; Kong, Weidan; Li, Xiaoyü; Xue, Qian; Zou, Yuan

doi:10.12998/wjcc.v9.i30.9070

Cited by 6 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An increase in globulin level is an independent risk factor for HT has been illustrated in patients receiving intra-arterial thrombolysis (Xing et al, 2014). Moreover, Zhong et al (2021) recently reported that the globulin level was also a risk factor for HT in patients with AIS after IVT. However, they measured globulin levels before thrombolysis.…”

Section: Discussionmentioning

confidence: 96%

“…Besides, serum globulin levels have been used to assess the severity of chronic inflammation (Wu et al, 2019). Some studies have found that globulin level was a risk factor for HT after IVT in patients with AIS (Zhong et al, 2021). However, no study has investigated the association between ALP and globulin levels and the long-term clinical outcomes after intravenous thrombolysis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic values of serum alkaline phosphatase and globulin levels in patients undergoing intravenous thrombolysis

Zhu

Sun

Guo

et al. 2022

Front. Mol. Neurosci.

View full text Add to dashboard Cite

BackgroundIn previous studies, alkaline phosphatase (ALP) level was a prognostic factor for patients with ischemic stroke, and globulin level was associated with hemorrhagic transformation (HT) after intravenous thrombolysis (IVT). However, the association between these serum biomarkers and prognosis in patients with acute ischemic stroke (AIS) who undergo IVT remains unclear. This study aimed to investigate the characteristics of serum ALP and globulin levels after IVT and to assess the relationship between these serum biomarkers and prognosis.Materials and methodsThis retrospective study used a prospectively collected database. We included patients with AIS who received recombinant tissue plasminogen activator (rt-PA) IVT. Demographic information, vascular risk factors, laboratory test results, and other stroke-related data were collected for analysis. Clinical outcomes included HT and 3-month poor outcome (modified Rankin Scale scores ≥ 2) after IVT. The association of ALP and globulin levels with HT and poor outcome was investigated using multivariate logistic regression analysis. An individualized prediction model based on ALP and globulin levels for functional outcomes was established.ResultsWe enrolled 750 patients in this study; 452 patients (60.3%) had poor outcome, and 117 patients (15.6%) had HT after IVT. After adjusting for all confounders, serum globulin level [OR = 1.055; 95% confidence intervals (CI): 1.006–1.107; P = 0.028] was independently associated with HT in patients with IVT. Serum ALP (OR = 1.009; 95% CI: 1.002–1.016; P = 0.010) and globulin levels (OR = 1.062; 95% CI: 1.020–1.107; P = 0.004) were associated with 3-month poor outcome in these patients. The constructed individualized prediction model for the 3-month poor outcome comprised the National Institutes of Health Stroke Scale (NIHSS) score, Trial of Org 10172 in Acute Stroke Treatment (TOAST), history of antihypertensive therapy, ALP and globulin levels. The area under the curve of the training and validation sets were 0.726 and 0.706, respectively, revealing that the model had good discriminating power. The P-values for the Hosmer-Lemeshow test in the training and validation sets were 0.978 and 0.148, respectively, indicating the model had good calibration.ConclusionThis study found that higher serum globulin levels were independently associated with HT. Additionally, higher serum ALP and globulin levels were independently associated with a poor outcome in patients after IVT.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Prognostic values of serum alkaline phosphatase and globulin levels in patients undergoing intravenous thrombolysis

Zhu

Sun

Guo

et al. 2022

Front. Mol. Neurosci.

View full text Add to dashboard Cite

show abstract

“…Albumin has been shown to have antioxidant, anti-inflammation, and anti-apoptosis in endothelial cells effects ( 25 ). Previous studies have shown that the decrease in albumin level or increase in globulin level might be associated with post-thrombolysis HT in ischemic stroke patients ( 26 , 27 ). Our study also showed that serum AGR ( P < 0.001) was related to post-thrombolysis HT in univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

A novel nomogram to predict hemorrhagic transformation in ischemic stroke patients after intravenous thrombolysis

Yang

Zhong²,

Zou³

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

BackgroundHemorrhagic transformation (HT) is the most serious complication of ischemic stroke patients after intravenous thrombolysis and leads to a poor clinical prognosis. This study aimed to determine the independent predictors associated with HT in stroke patients with intravenous thrombolysis and to establish and validate a nomogram that combines with predictors to predict the probability of HT after intravenous thrombolysis in patients with ischemic stroke.MethodThis study enrolled ischemic stroke patients with intravenous thrombolysis from December 2016 to June 2022. All the patients were divided into training and validation cohorts. The nomogram was composed of the significant predictors for HT in the training cohort as obtained by the multivariate logistic regression analysis. The area under the receiver operating characteristic curve was used to assess the discriminative performance of the nomogram. The calibration performance of the nomogram was assessed by the Hosmer–Lemeshow goodness-of-fit test and calibration plots. Decision curve analysis was used to test the clinical validity of the nomogram.ResultsA total of 394 patients with intravenous thrombolysis were enrolled in the study. In the training cohort (n = 257), 45 patients had HT after intravenous thrombolysis. Multivariate logistic regression analysis demonstrated early infarct signs (OR, 7.954; 95% CI, 3.553-17.803; P < 0.001), NIHSS scores (OR, 1.110; 95% CI, 1.054-1.168; P < 0.001), uric acid (OR, 0.993; 95% CI, 0.989–0.997; P = 0.001), and albumin-to-globulin ratio (OR, 0.109; 95% CI, 0.023–0.508; P = 0.005) were independent predictors for HT and constructed the nomogram. In the training and validation cohorts, the AUC of the nomogram was 0.859 and 0.839, respectively. The Hosmer–Lemeshow goodness-of-fit test and calibration plot showed good concordance between predicted and observed probability in the training and validation cohorts. Decision curve analysis indicated that the nomogram was significantly useful for predicting HT in the training and further confirmed in the validation cohort.ConclusionThis study proposes a novel and practical nomogram based on early infarct signs, NIHSS scores, uric acid, and albumin-to-globulin ratio that can well predict the probability of HT after intravenous thrombolysis in patients with ischemic stroke.

show abstract

“…This study also found that leukocytes might serve a mediating effect between A/G and SAP, which further confirmed that inflammatory mechanisms might play an essential role between A/G and SAP. A third possibility is that high levels of albumin and low levels of globulin have neuroprotective effects, which may influence the risk of SAP by detoxifying endogenous and exogenous molecules, maintaining the integrity of the blood-brain barrier, increasing hypoxia tolerance, decreasing brain edema, and modulating neural apoptosis and inflammation reactions (23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of albumin to globulin ratio among patients with stroke-associated pneumonia

Chen

Huang

et al. 2022

Front. Nutr.

View full text Add to dashboard Cite

BackgroundIt has been proven that the ratio of albumin to globulin (A/G) is a typical biomarker for monitoring inflammation and nutritional status. But the potential role of A/G in stroke-associated pneumonia (SAP) after acute ischemic stroke (AIS) remained unknown.Patients and methodsFollowing inclusion criteria, 5,173 AIS patients were included and segmented into SAP (n = 897) and non-SAP (n = 4,276) groups. The differences in variables between groups were compared. The logistic regression model was used to determine the association between A/G and SAP, and a forest plot was drawn.ResultsCompared with the non-SAP group, the SAP group had a lower A/G level (P < 0.001). Then, A/G was divided into quartiles. In comparison to Q3 (A/G = 1.25–1.39), logistic regression revealed that patients with a lower A/G (A/G ≤ 1.09) had a higher risk of SAP (OR = 1.96, 95% CI, 1.56–2.46, P < 0.001). On the contrary, those with a higher A/G (A/G ≥ 1.4) had a lower SAP risk (OR = 0.73, 95% CI, 0.54–0.97, P = 0.029).ConclusionThe study revealed that a low A/G level was associated with an increased SAP risk. Appropriate preventative measures for SAP should be taken in AIS patients with a low A/G level.

show abstract

Serum calcium, albumin, globulin and matrix metalloproteinase-9 levels in acute cerebral infarction patients

Cited by 6 publications

References 20 publications

Prognostic values of serum alkaline phosphatase and globulin levels in patients undergoing intravenous thrombolysis

Prognostic values of serum alkaline phosphatase and globulin levels in patients undergoing intravenous thrombolysis

A novel nomogram to predict hemorrhagic transformation in ischemic stroke patients after intravenous thrombolysis

Clinical significance of albumin to globulin ratio among patients with stroke-associated pneumonia

Contact Info

Product

Resources

About