Abstract
Background: Sphingosine 1-phosphate (S1P) is a lipid metabolite that mediates various physiological processes, including vascular endothelial cell function, inflammation, coagulation/thrombosis, and angiogenesis. As a result, S1P may contribute to the pathogenesis of stroke.Objective: This study aimed to evaluate the diagnostic value of serum S1P in acute stroke.Method: A total of 72 patients with ischemic stroke, 36 patients with hemorrhagic stroke, and 65 controls were enrolled. Serum S1P was detected by enzyme-linked immunosorbent assay (ELISA).Results: Receiver operating characteristic curve analysis demonstrated that serum S1P could discriminate ischemic stroke from hemorrhagic stroke in both total population and subgroup analyses of samples obtained within 24 h of symptom onset (subgroup < 24h) (area under curve, AUCTotal = 0.64, P = 0.017; AUCSubgroup < 24h = 0.91, P < 0.001) and controls (AUCTotal = 0.62, P = 0.013; AUCSubgroup <24h = 0.83, P < 0.001). Furthermore, S1P showed higher efficacy than high-density lipoprotein cholesterol (HDL-C) in discriminating ischemic stroke from controls in the total population (PS1P = 0.013, PHDL−C = 0.366) and in the subgroup analysis (i.e., <24 h; PS1P < 0.001, PHDL−C = 0.081). Additionally, lower serum S1P was associated with cervical artery plaques (P = 0.021) in controls and with dyslipidemia (P = 0.036) and milder neurological impairment evaluated by the National Institute of Health Stroke Scale (NIHSS, P = 0.047) in the ischemic stroke group.Conclusions: The present study preliminarily investigated the diagnostic value of serum S1P in acute stroke. Decreased serum S1P may become a potential biomarker for early acute ischemic stroke and can indicate disease severity.
Highlights
Stroke is a severely disabling neurological disease that encompasses both ischemic and hemorrhagic strokes [1, 2]
There was no significant difference in age at sampling among the three groups, while the ischemic stroke group had a higher proportion of male patients than the controls (P = 0.036)
As for the conventional vascular risk factors, the ischemic stroke group showed a higher proportion of patients with a smoking habit compared with the controls (P < 0.01), as well as a higher proportion of patients with alcohol abuse compared with both control (P < 0.01) and hemorrhagic stroke groups (P = 0.025)
Summary
Stroke is a severely disabling neurological disease that encompasses both ischemic and hemorrhagic strokes [1, 2]. To diagnose stroke, neuroimaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) play an important role in the clinical setting. Biomarkers have been proven to contribute to diagnosis, to discriminate stroke type, and to identify patients’ risk factors, which guide treatment [5, 6]. There have been an increasing number of candidate biomarkers for stroke identified in the past decade. Such candidate biomarkers include monitoring biological indicators of coagulation, excitotoxicity, oxidative stress, inflammation, blood–brain barrier dysfunction, and necrosis or apoptosis; none have been widely applied in clinical practice [7,8,9]. S1P may contribute to the pathogenesis of stroke
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