Correlation Analysis Between High-Density Lipoprotein Cholesterol-Carried microRNA-28-5p and Acute Ischemic Stroke

Abstract

This paper aimed to disclose the correlation of high-density lipoprotein cholesterol (HDL-C)-carried microRNA-28-5p (miR-28-5p) with acute ischemic stroke (AIS). This study retrospectively included 216 first-diagnosed AIS patients (study subjects) and 102 healthy people (controls). Clinical data, serum total cholesterol (TC), triglycerides (TG), glucose, homocysteine (Hcy), HDL-C, low-DL-C (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), and fasting serum samples were collected. Serum miR-28-5p levels and disease severity were assessed by RT-qPCR and National Institutes of Health Stroke Scale (NIHSS). The diagnostic efficacy of miR-28-5p and Hcy for AIS and disease severity was evaluated using ROC curves. miR-28-5p was upregulated in AIS patients, positively correlated with HDL-C (p < 0.001, r = 0.848), and negatively correlated with TC (p < 0.001, r = 0.673). HDL-C-carried miR-28-5p was an independent influencing factor for AIS (p = 0.027, OR = 1.294, 95% CI = 1.030-1.626) and helped diagnose AIS (AUC = 0.938, 95% CI = 0.912-0.963). miR-28-5p was positively correlated with NIHSS scores (p < 0.001, r = 0.777) in AIS patients, and provided diagnostic value for AIS (positive predictive value [PPV] = 96.907%, negative predictive value [NPV] = 77.419%) and AIS severity (PPV = 95.200%, NPV = 75.824%). PPV > 95% and NPV < 90% suggested that miR-28-5p offered auxiliary diagnostic value for AIS and its severity, with limited diagnostic accuracy, and there might be a relatively high risk of missed diagnosis. The combination of miR-28-5p and Hcy improved the diagnostic value of miR-28-5p alone for AIS and its severity. Collectively, HDL-C-carried miR-28-5p is highly expressed in AIS patients and positively correlated with NIHSS score. It is an independent influencing factor for AIS and may assist in diagnosing AIS and its severity. Additionally, miR-28-5p combined with Hcy can increase the diagnostic value of miR-28-5p single detection for AIS and its severity.

Keywords: National Institutes of Health Stroke Scale; Pearson and Spearman correlation analyses; ROC curve analysis; acute ischemic stroke; correlation analysis; high‐density lipoprotein cholesterol; logistic univariate and multivariate analyses; microRNA‐28‐5p.