A retrospective study of immunoglobulin E as a biomarker for the diagnosis of acute ischemic stroke with carotid atherosclerotic plaques

Increased Hepatorenal Index Is Associated with the Risk of Developing Stroke in Patients with Nonalcoholic Fatty Liver Disease

OBJECTIVE

The aim of this study was to examine the relationship between the sonographic hepatorenal index and stroke risk in patients with nonalcoholic fatty liver disease (NAFLD).

METHODS

From December 2023 to July 2024, 72 NAFLD patients with stroke, 53 stroke-free NAFLD patients, and 54 healthy controls were enrolled in our study. The hepatorenal index was calculated as the ratio of the echo intensity of the liver to that of the renal cortex. The mean brightness values for one region of interest within the right hepatic lobe and the other size-matched region at the same depth of field within the right kidney were obtained with two-dimensional ultrasound and a 1- to 6-MHz convex array probe. Laboratory tests were performed with a Cobas 8000 automatic biochemical analyzer. Univariate and multivariate analyses were adopted to analyze the risk factors for stroke in NAFLD patients.

RESULTS

NAFLD patients had a greater hepatorenal index than healthy controls did (P < 0.05). Additionally, NAFLD patients with stroke had an even greater hepatorenal index than did those with stroke-free NAFLD (P < 0.001). Multivariate regression analysis further revealed that the hepatorenal index was independently associated with stroke risk in NAFLD patients (β = 8.897, P < 0.001) after controlling for age, body mass index, systolic blood pressure, and serum glucose, total cholesterol, alanine transaminase, and creatinine concentrations. Receiver operating characteristic curve analysis revealed a sensitivity of 62.5% and specificity of 95.3% for the hepatorenal index, with a cutoff value of 1.255 and an area under the curve of 0.80.

CONCLUSION

The increased sonographic hepatorenal index could be an independent predictor of stroke development in patients with NAFLD.

Expression and clinical significance of 25-hydroxyvitamin D, insulin-like growth factor 1, and beta-2 microglobulin in cognitive dysfunction after ischemic stroke in the elderly

We aimed to unveil the clinical significance of serum 25-hydroxyvitamin D (25-OH-VD), insulin-like growth factor 1 (IGF-1), and beta-2 microglobulin (β2-MG) levels in cognitive dysfunction after ischemic stroke (IS) in the elderly. A total of 160 geriatric IS patients admitted to our hospital were retrospectively collected. The patients' serum 25-OH-VD, IGF-1, and β2-MG levels were detected, and the correlation between the three levels and the patients' National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment (MoCA) scores was tested by the Pearson test. The diagnostic values of 25-OH-VD, IGF-1, and β2-MG for cognitive dysfunction and risk factors inducing cognitive dysfunction in the elderly after IS were evaluated. NIHSS score was negatively correlated with serum 25-OH-VD and IGF-1 levels, and positively correlated with serum β2-MG levels; MoCA score exhibited an inverse correlation. Diabetes, years of education <12 years, age, and serum high-sensitive C-reactive protein, cystatin C, 25-OH-VD, IGF-1, and β2-MG levels were independent factors for the development of cognitive dysfunction after IS in the elderly. The detection of 25-OH-VD, IGF-1, and β2-MG may be important for assessing the occurrence of cognitive dysfunction and the severity of the disease in patients.

Cellular and Molecular Mechanisms of Mast Cells in Atherosclerotic Plaque Progression and Destabilization

Mast cells (MCs) are commonly recognized for their crucial involvement in the pathogenesis of allergic diseases, but over time, it has come to light that they also play a role in the pathophysiology of non-allergic disorders including atherosclerosis. The involvement of MCs in the pathology of atherosclerosis is supported by their accumulation in atherosclerotic plaques upon their progression and the association of intraplaque MC numbers with acute cardiovascular events. MCs that accumulate within the atherosclerotic plaque release a cocktail of mediators through which they contribute to neovascularization, plaque progression, instability, erosion, rupture, and thrombosis. At a molecular level, MC-released proteases, especially cathepsin G, degrade low-density lipoproteins (LDL) and mediate LDL fusion and binding of LDL to proteoglycans (PGs). Through a complicated network of chemokines including CXCL1, MCs promote the recruitment of among others CXCR2+ neutrophils, therefore, aggravating the inflammation of the plaque environment. Additionally, MCs produce extracellular traps which worsen inflammation and contribute to atherothrombosis. Altogether, evidence suggests that MCs actively, via several underlying mechanisms, contribute to atherosclerotic plaque destabilization and acute cardiovascular syndromes, thus, making the study of interventions to modulate MC activation an interesting target for cardiovascular medicine.