新型脂肪因子Asprosin Irisin与急性缺血性脑卒中及病情严重程度的相关性研究
王开开1） 钟莲梅2） 侯 倩1）
1）青海省人民医院，青海 西宁 810007
2）昆明医科大学第一附属医院，云南 昆明 650032
通信作者：侯倩
【摘要】 目的 探讨新型脂肪因子白脂素（Asprosin）、鸢尾素（Irisin）是否可作为急性缺血性脑卒中（AIS）的新型生物学标志物及与病情严重程度的关系。方法 选取2021-03—2021-09 在青海省人民医院神经内科诊治的 90 例 AIS 患者为病例组，于本院体检的非 AIS 者 80 例为对照组；根据是否患代谢综合征（MS）分为 MS 合并 AIS 组、单纯 AIS 组、单纯 MS 组及健康组，依据 NIHSS 评分将病例组分为轻度、中度及重度 3 组。采用酶联免疫吸附试验测定研究对象血清 Asprosin、Irisin 水平，通过受试者工作特征曲线分析 Asprosin、Irisin 对 AIS 诊断及预测价值，应用多元逐步线性回归分析 AIS 病情严重程度的影响因素。结果 病例组患者血清 Asprosin、Irisin 水平高于对照组［Asprosin:（3.30±1.35）ng/mL 比（1.71±0.91）ng/mL，Irisin（147.88±46.05）ng/mL 比（110.10±44.66）ng/mL，均 P<0.001］，MS 合并 AIS 患者血清 Asprosin 水平（3.57±1.23 ng/mL）高于单纯 MS 患者［（2.04±1.05）ng/mL，P<0.001］及健康者［（1.38±0.60）ng/mL，P<0.001］，而 MS 合并 AIS 患者血清 Irisin 水平［（134.31±42.04）ng/mL）］高于健康者［（96.41±36.31）ng/mL，P<0.001］，但低于单纯 AIS 患者［（164.83±45.70）ng/mL，P=0.007］。Asprosin、Irisin 对 AIS 诊断的曲线下面积分别为 0.831、0.724（P<0.001）。Asprosin 水平与 AIS 病情严重程度呈正相关（r=0.827，P<0.001），而Irisin 水平随 AIS 患者病情严重程度的增加呈先升高（r=0.489，P=0.029）后降低（r=-0.742，P<0.001）的趋势；Asprosin 为 AIS 患者病情严重的危险因素（Β=2.445，95%CI：1.883~3.007，P<0.001），而 Irisin 为 AIS 患者病情严重的保护性因素（Β=-0.030，95%CI：-0.045~-0.014，P<0.001）。结论 新型脂肪因子 Asprosin、Irisin 在青海地区 AIS 患者中表达增高，可作为诊断和预测 AIS 潜在的新型生物学标志物。Asprosin 为 AIS 病情严重的危险因素，Irisin 是 AIS 病情严重的保护性因素并具有一定代偿能力。
【关键词】 急性缺血性脑卒中；白脂素；鸢尾素；新型生物学标志物；病情严重程度
【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1673-5110 （2022） 04-0403-06
基金项目：中国卒中学会脑血管病全程管理项目启航基金（编号：2020017）
DOI：10.12083/SYSJ.220067
Study on the correlation between new adipokines Asprosin，Irisin and acute ischemic stroke and severity
WANG Kaikai1） ，ZHONG Lianmei2） ，HOU Qian1）
1）Qinghai Provincial People’s Hospital，Xi’ning 810007，China
2）The First Affiliated Hospital of Kunming Medical University，Kunming 650032，China
Corresponding author：HOU Qian
【Abstract】 Objective markers of acute ischemic stroke To explore whether the new adipokines Asprosin and Irisin are new biological （AIS）and their relationship with the severity of AIS. Methods A total of 90 AIS patients diagnosed and treated in the Department of Neurology of our hospital from March 2021 to September 2021 were selected as the case group，and 80 non-AIS patients undergoing physical examination in our hospital during the same period were selected as the control group. According to whether they suffer from MS，they were divided into four groups: MS combined with AIS，simple AIS，simple MS，and healthy. According to the NIHSS score，the cases were divided into three groups: mild，moderate and severe. Enzyme-linked immunosorbent assay was used to determine the subjects’serum Asprosin and Irisin levels. The diagnostic and predictive value of Asprosin and Irisin for AIS were analyzed by receiver operating characteristic（ROC）curve. Multiple stepwise linear regression was used to analyze the influencing factors of the severity of AIS. Results Serum Asprosin and Irisin levels in the case group were higher than those in the control group（Asprosin:（3.30±1.35）ng/mL vs （1.71±0.91）ng/mL，Irisin（147.88±46.05）ng/mL vs （110.10±44.66）ng/mL，all P<0.001）. The serum Asprosin level of AIS patients with MS（3.57±1.23 ng/mL）was higher than that of simple MS patients（（2.04±1.05）ng/mL，P<0.001）and healthy individuals（（1.38±0.60）ng/mL，P<0.001）. The serum Irisin level of AIS patients with MS （134.31±42.04）ng/mL was higher than that of healthy patients（（96.41±36.31）ng/mL，P<0.001），but lower than that of patients with AIS alone（（164.83±45.70）ng/mL，P=0.007）. The area under the curve of Asprosin and Irisin for diagnosis of AIS were 0.831 and 0.724（all P<0.001），respectively. The level of Asprosin increased with the severity of AIS patients（r=0.827，P<0.001），and the level of Irisin increased first（r=0.489，P=0.029） and then decreased（r= — 0.742，P<0.001）with the increase of severity of AIS patients. Asprosin was the risk factor for the severity of AIS patients（Β=2.445，95%CI：1.883~3.007，P<0.001）and Irisin was the protective factor for the severity of AIS patients Β=-0.030，95% CI：-0.045~-0.014，P<0.001）. Conclusion The expression of new adipokines Asprosin and Irisin are increased in AIS patients of Qinghai，and they can be used as potential new biological markers for the diagnosis and prediction of AIS. Asprosin is the risk factor for the severity of AIS，and Irisin is a protective factor for the severity of AIS and has a certain compensatory ability.
【Key words】 Acute ischemic stroke；Asprosin；Irisin；New biological markers；Severity
