Correlation between serum parathyroid hormone-associated protein concentration and acute ischemic stroke

Abstract

Objective To investigate the correlation between serum Parathyroid hormone-related protein (PTHrP) and acute ischemic stroke (AIS). Methods from October 2020 to March 2021, 134 patients with AIS and 34 healthy individuals were enrolled. Serum PTHrP concentration was measured by enzyme-linked immunosorbent assay (ELISA) and subgroup analysis was performed according to Trial of Org 10 172 in acute stroke treatment (TOAST) classification. The severity of AIS was assessed by the National Institutes of Health stroke scale (NIHSS) score and the volume of cerebral infarction was assessed based on head magnetic resonance imaging. The correlation of serum PTHrP concentration with various indicators was analyzed. The 90-day functional prognosis of patients was assessed by the modified Rankin scale. Patients were divided into favorable outcomes group and unfavorable outcomes group and the difference in serum PTHrP concentration between the two groups was compared. Whether serum PTHrP was associated with AIS prognosis was analyzed by Logistic regression.Results The serum PTHrP concentration in AIS group was higher than that in the control group (P=0.000), and the serum PTHrP concentrations of the three common etiological subtypes, LAA, CE and SAO, were higher than those in the control group (all P<0.01). The AUC for distinguishing AIS patients and healthy control by serum PTHrP concentration was 0.751(P<0.0001). The serum PTHrP concentration in the AIS group was associated with the cumulative smoking volume (r=0.201, P=0.021) and APTT (r=-0.188, p=0.034). Serum PTHrP was not associated with TOAST classification (P=0.091), NIHSS score and cerebral infarction volume (all P>0.05), and there was no significant difference in serum PTHrP concentration between the favorable outcomes group and unfavorable outcomes group (P> 0.05). Univariate logistic regression showed that serum PTHrP concentration was not a prognostic factor of AIS [OR=1.000 95% CI (0.999, 1.002) P=0.678]. Conclusion Serum PTHrP concentration was significantly increased in AIS patients. Serum PTHrP might be ancillary for early identification of AIS. Serum PTHrP concentration correlated with cumulative smoking volume and APTT in AIS patients, and could possibly be used to assess the true smoking volume of patients and analyze coagulation function. However, serum PTHrP concentration was not associated with TOAST classification, NIHSS score, cerebral infarction volume and 90-day prognosis, which meant it cannot be used to evaluated the etiology, severity and prognosis of AIS patients.