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BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Stroke | Research article

Correlation of lipoprotein-associated phospholipase A2 and cerebral microbleeds in patients with acute ischaemic stroke

Authors: Xiaojiu Zhang, Lu Liu, Nan Jiang, Yufeng Liu, Qing Wang, Xiaohong Tang, Qijin Zhai, Liandong Zhao

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background and aims

Cerebral microbleeds (CMBs) increase the risk of stroke occurrence and recurrence,and affect the prognosis of stroke patients. Therefore, identifying biological markers that predict CMBs after stroke is urgently needed. This study explored whether high levels of lipoprotein-associated phospholipase A2(Lp-PLA2) are associated with an increased risk of CMBs in patients with acute ischaemic stroke (AIS).

Methods

From April 2020 to October 2021, we enrolled 242 patients with AIS. At admission, the plasma levels of Lp-PLA2 were measured in all patients as well as the number of CMBs and white matter lesions. According to the results of the Susceptibility Weighted Imaging (SWI), the patients were divided into a CMB group and a no-CMB group. The groups were compared with univariate and multivariate analyses to clarify the correlation between Lp-PLA2 levels and CMBs, and the optimal cut-off value of Lp-PLA2 that predicted CMBs was determined from the receiver-operating characteristic curve.

Results

CMBs were detected in 71 (29.3%) of the 242 AIS patients. The median Lp-PLA2 level was 182.79 ng/ml. Using the 1st quartile of Lp-PLA2 levels (the lowest levels) as the reference group, univariate logistic regression analysis showed that individuals in the 4th quartile (the highest levels) had a higher risk of CMBs (odds ratio [OR] = 1.460, 95% confidence interval [CI]: 1.188–1.795, P = 0.000). This correlation persisted after adjusting for relevant risk factors (OR = 1.370, 95% CI: 1.096–1.713, P = 0.006). The optimal cut-off value of Lp-PLA2 that predicted the occurrence of CMBs was 184.36 ng/ml; at this threshold, the sensitivity was 69.0%, and the specificity was 60.2%.

Conclusions

Our data suggest that a high level of Lp-PLA2 in patients with AIS is a potential risk factor for CMBs.
Appendix
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Literature
1.
Viswanathan A, Chabriat H. Cerebral microhemorrhage. Stroke. 2006;37(2):550–5.CrossRef
2.
Cordonnier C, Al-Shahi Salman R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting. Brain. 2007;130(Pt 8):1988–2003.CrossRef
3.
Charidimou A, Shams S, Romero JR, et al. Clinical significance of cerebral microbleeds on MRI: a comprehensive meta-analysis of risk of intracerebral hemorrhage, ischemic stroke, mortality, and dementia in cohort studies (v1). Int J Stroke. 2018;13(5):454–68.CrossRef
4.
Wilson D, Ambler G, Lee KJ, et al. Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies. Lancet Neurol. 2019;18(7):653–65.CrossRef
5.
Xu CX, Xu H, Yi T, Yi XY, Ma JP. Cerebral microbleed burden in ischemic stroke patients on aspirin: prospective cohort of intracranial hemorrhage. Front Neurol. 2021;12:742899.CrossRef
6.
Capuana ML, Lorenzano S, Caselli MC, Paciaroni M, Toni D. Hemorrhagic risk after intravenous thrombolysis for ischemic stroke in patients with cerebral microbleeds and white matter disease. Neurol Sci. 2021;42(5):1969–76.CrossRef
7.
Gu Y, Gutierrez J, Meier IB, Guzman VA, Manly JJ, Schupf N, et al. Circulating inflammatory biomarkers are related to cerebrovascular disease in older adults. Neurol Neuroimmunol Neuroinflamm. 2019;6(1):e521.CrossRef
8.
Low A, Mak E, Rowe JB, Markus HS, O’Brien JT. Inflammation and cerebral small vessel disease: a systematic review. Ageing Res Rev. 2019;53:100916.CrossRef
9.
Liang Q, Lei X, Huang X, Fan L, Yu H. Elevated lipoprotein-associated phospholipase A2 is valuable in prediction of coronary slow flow in non-ST-segment elevation myocardial infarction patients. Curr Probl Cardiol. 2021;46(3):100596.CrossRef
10.
Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ. 1976;54(5):541–53.
11.
Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12(8):822–38.CrossRef
12.
Adachi M, Sato T. Characterization of the growth of deep and subcortical white matter Hyperintensity on MR imaging: a retrospective cohort study. Magn Reson Med Sci. 2017;16(3):238–44.CrossRef
13.
Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351–6.CrossRef
14.
Wach-Klink A, Iżycka-Świeszewska E, Kozera G, Sobolewski P. Cerebral microbleeds in neurological practice: concepts, diagnostics and clinical aspects. Neurol Neurochir Pol. 2021;55(5):450–61.CrossRef
15.
Shao L, Wang M, Ge XH, Huang HD, Gao L, Qin JC. The use of susceptibility-weighted imaging to detect cerebral microbleeds after lacunar infarction. Eur Rev Med Pharmacol Sci. 2017;21(13):3105–12.
16.
Hageman G, Hof J, Nihom J. Susceptibility-weighted MRI and microbleeds in mild traumatic brain injury: prediction of posttraumatic complaints. Eur Neurol. 2022;85(3):177–85.CrossRef
17.
Lerman A, McConnell JP. Lipoprotein-associated phospholipase A2: a risk marker or a risk factor. Am J Cardiol. 2008;101(12A):11F–22F.CrossRef
18.
Silva IT, Mello AP, Damasceno NR. Antioxidant and inflammatory aspects of lipoprotein-associated phospholipase a2 (Lp-PLA2): a review. Lipids Health Dis. 2011;10:170.CrossRef
19.
Zheng H, Cui D, Quan X, Yang W, Li Y, Zhang L, et al. Lp-PLA2 silencing protects against ox-LDL-induced oxidative stress and cell apoptosis via Akt/mTOR signaling pathway in human THP1 macrophages. Biochem Biophys Res Commun. 2016;477(4):1017–23.CrossRef
20.
Fatemi S, Gottsäter A, Zarrouk M, Engström G, Melander O, Persson M, et al. Lp-PLA (2) activity and mass and CRP are associated with incident symptomatic peripheral arterial disease. Sci Rep. 2019;9(1):5609.CrossRef
21.
Hu G, Liu D, Tong H, Huang W, Hu Y, Huang Y. Lipoprotein-associated phospholipase A2 activity and mass as independent risk factor of stroke: a Meta-analysis. Biomed Res Int. 2019;2019:8642784.CrossRef
22.
Wei L, Ke Z, Zhao Y, Cai Z. The elevated lipoprotein-associated phospholipase A2 activity is associated with the occurrence and recurrence of acute cerebral infarction. Neuroreport. 2017;28(6):325–30.CrossRef
23.
Wang Y, Hu S, Ren L, Lei Z, Lan T, Cai J, et al. Lp-PLA (2) as a risk factor of early neurological deterioration in acute ischemic stroke with TOAST type of large arterial atherosclerosis. Neurol Res. 2019;41(1):1–8.CrossRef
24.
Li X, Xu L, Xu Z. The diagnostic and prognostic performance of Lp-PLA2 in acute ischemic stroke. Med Clin (Barc). 2021;156(9):437–43.CrossRef
25.
Bonnefont-Rousselot D. Lp-PLA2, a biomarker of vascular inflammation and vulnerability of atherosclerosis plaques. Ann Pharm Fr. 2016;74(3):190–7.CrossRef
26.
Saint-Pol J, Gosselet F, Duban-Deweer S, Pottiez G, Karamanos Y. Targeting and crossing the blood-brain barrier with extracellular vesicles. Cells. 2020;9(4):851.
27.
Wadi LC, Grigoryan MM, Kim RC, Fang C, Kim J, Corrada MM, et al. Mechanisms of cerebral microbleeds. J Neuropathol Exp Neurol. 2020;42(2):1093–9.
28.
Romero JR, Preis SR, Beiser AS, et al. Lipoprotein phospholipase A2 and cerebral microbleeds in the Framingham heart study. Stroke. 2012;43(11):3091–4.CrossRef
29.
Liu Y, Liu X, Zhang X, Hou C, Tang P. Study on the Relationship between Lipoprotein-related Phospholipase A2,Homocysteine,Beta-N-1-Deoxy Fructosyl Component of Hemoglobin and Cerebral Micobleeds. J Modern Lab Med. 2017;32(6):35–8.
30.
Jellinger PS, Smith DA, Mehta AE, Ganda O, Handelsman Y, Rodbard HW, et al. American Association of Clinical Endocrinologists’ guidelines for Management of Dyslipidemia and Prevention of atherosclerosis. Endocr Pract. 2012;18(Suppl 1):1–78.CrossRef
31.
Ntzouvani A, Giannopoulou E, Fragopoulou E, Nomikos T, Antonopoulou S. Energy intake and plasma Adiponectin as potential determinants of lipoprotein-associated phospholipase a (2) activity: a cross-sectional study. Lipids. 2019;54(10):629–40.CrossRef
32.
Xi H, Cheng GL, Hu FF, Li SN, Deng X, Zhou Y. The use of lipoprotein-associated phospholipase A2 in a Chinese population to predict cardiovascular events. Biomed Environ Sci. 2022;35(3):206–14.
Metadata
Title
Correlation of lipoprotein-associated phospholipase A2 and cerebral microbleeds in patients with acute ischaemic stroke
Authors
Xiaojiu Zhang
Lu Liu
Nan Jiang
Yufeng Liu
Qing Wang
Xiaohong Tang
Qijin Zhai
Liandong Zhao
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-03000-w

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