Relationship between galectin-3 and the severity of cerebral artery atherosclerosis and the prognosis of patients with large artery atherosclerotic stroke

Abstract

Objective To investigate the relationship between the plasma galectin-3 level and the severity of cerebral artery atherosclerosis as well as the prognosis of patients with large artery atherosclerosis (LAA) stroke. Methods According to the TOAST classification, 105 patients with LAA stroke, 50 patients with small artery occlusion (SAO) stroke, 33 patients with asymptomatic cerebral artery stenosis, and 60 healthy controls were enrolled. The plasma galectin-3 level was measured using enzyme-linked immunosorbent assay. According to the number of cerebral arteries with atherosclerosis, the LAA group was divided into single-branch lesions group (n=30), double-branch lesions group (n=30) and multi-branch lesions group (n=45). Plasma galectin-3 levels were compared among the three subgroups, and the associations between galectin-3 and the severity of cerebral atherosclerosis were analyzed. The LAA group patients were followed up for three months, and the value of galectin-3 on predicting the prognosis of patients with LAA stroke was assessed using the receiver operating characteristic (ROC) curve and the modified Rankin scale (mRS) scores. Results The plasma galectin-3 level in LAA group ((13.64±3.08) ng/ml) was significantly higher than in SAO group ((12.20±2.88) ng/ml) and control group ((11.89±2.93) ng/ml; t=2.790, 3.617, P=0.006, 0.000). Besides, the plasma galectin-3 level in asymptomatic stenosis group ((13.94±2.89) ng/ml) was significantly higher than in SAO group and control group (t=2.695, 3.238, P=0.009, 0.002). However, the differences between asymptomatic stenosis group and LAA group, SAO group and control group were not statistically significant. In LAA group, the plasma galectin-3 level in multi-branch lesions group ((15.02±2.94) ng/ml) was significantly higher than in double-branch lesions group ((13.47±2.88) ng/ml) and single-branch lesions group ((11.73±2.43) ng/ml; t=2.261, 5.080, P=0.027, 0.000). The plasma galectin-3 level in double-branch lesions group was significantly higher than in single-branch lesions group (t=2.532, P=0.014). The plasma galectin-3 level and the range of atherosclerosis and mRS scores were positively correlated (r=0.433, 0.629; P=0.000, 0.000). The area under the ROC curve of plasma galectin-3 level and prognosis was 0.812 (95% CI 0.726-0.897, P=0.000). Conclusions The plasma galectin-3 level was found associated with the severity of cerebral artery atherosclerosis, but not with acute onset of LAA and SAO stroke. Galectin-3 may be involved in the inflammatory pathogenesis and development of cerebral atherosclerosis, and may have the potential to become a plasma marker for evaluating the severity of cerebral artery atherosclerosis and judging the prognosis of patients with LAA stroke. Key words: Galectin-3; Stroke; Cerebral atherosclerosis; Inflammation; Prognosis