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. 2025 Jul 3;25(1):274.
doi: 10.1186/s12883-025-04295-1.

An indicator of antioxidant stress ability to evaluate neurofunctional changes in patients with acute ischemic stroke: preliminary findings

Wei-Chong Dong  1   2   3 , Xin-Hui Jiang  4 , Cheng-Hao Chang  5 , Lei Xu  6 , Jing Liu  7 , Jia-Liang Guo  8 , Ye Jiang  9   10 , Ying-Ze Zhang  11   12
Affiliations

An indicator of antioxidant stress ability to evaluate neurofunctional changes in patients with acute ischemic stroke: preliminary findings

Wei-Chong Dong et al. BMC Neurol. .

Abstract

Background: Acute ischemic stroke (AIS) ranks among the most prevalent cerebrovascular conditions. The clinical interest lies in utilizing oxidative stress (OS) markers and antioxidant system indicators for diagnosing and predicting stroke development. Our objective was to identify a precise marker of antioxidant stress ability to assess neurofunctional alterations in AIS patients.

Methods: A total of 66 AIS patients, 33 of whom also had type 2 diabetes mellitus (T2DM), were selected for our study, and 30 patients without AIS and diabetes were used as controls. The total plasma homocysteine (Hcy) concentrations were determined via an enzymatic cycling assay. The reduced Hcy to oxidised Hcy concentration ratio (Hcy/HHcy) was determined using hollow fibre centrifugal ultrafiltration (HFCF-UF) technique we previously established.

Results: The Hcy/HHcy was significantly lower in AIS patients with T2DM compared with both controls (P = 0.0262) and AIS patients without T2DM (P = 0.0468). A positive correlation was found between total Hcy concentration and the National Institutes of Health Stroke Scale (NIHSS) score (P = 0.002, r = 0.561), while no correlation was observed in AIS patients without T2DM (P = 0.850, r=-0.034). In AIS patients, the Hcy/HHcy showed a positive correlation with the NIHSS score in those with T2DM (P = 0.037, r = 0.365) and a negative correlation in those without T2DM (P = 0.003, r=-0.497). In AIS patients with T2DM, the receiver operating characteristic's area under the curve (ROC-AUC) value for total Hcy concentration was 0.796, compared to 0.600 in those without T2DM. Furthermore, the ROC-AUC values of the Hcy/HHcy were 0.719 and 0.735 in AIS patients with and without T2DM, respectively.

Conclusion: Hcy/HHcy is anticipated to serve as a precise indicator for assessing antioxidant stress ability and evaluating neurofunctional alterations in AIS patients.

Keywords: Acute ischemic stroke; Antioxidant stress ability; Homocysteine; Homocystine; Neurofunctional changes.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study complies with the Declaration of Helsinki. The Ethics Committee of Hebei Medical University approved the study protocol (No.2021026), and informed consent was obtained from all participants. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representative MRM chromatograms of Hcy-NEM, homocystine (HHcy), and IS (Hcy-D4-NEM) in clinical plasma samples
Fig. 2
Fig. 2
Results of total Hcy and the Hcy/HHcy for group comparisons (Control; Group A: 33 AIS patients with T2DM; Group B: 33 AIS patients without T2DM; P represents the values of two-group comparisons; *P represents the values of three-group comparisons)
Fig. 3
Fig. 3
The results of the Spearman’s rank correlation for total Hcy concentration with the NIHSS score (A: 33 AIS patients with T2DM; B: 33 AIS patients without T2DM)
Fig. 4
Fig. 4
The results of the Spearman’s rank correlation for the Hcy/HHcy with the NIHSS score (A: 33 AIS patients with T2DM; B: 33 AIS patients without T2DM)
Fig. 5
Fig. 5
ROC curves for total Hcy A and the Hcy/HHcy B with neurofunctional changes in AIS patients with T2DM
Fig. 6
Fig. 6
ROC curves for total Hcy A and the Hcy/HHcy B with neurofunctional changes in AIS patients without T2DM
Fig. 7
Fig. 7
The results of the Hcy/HHcy levels among different stroke subtypes (1. large artery atherosclerosis; 2. cardioembolism; 3. small vessel occlusion; 4. other determined causes, such as dissection, mitochondrial or genetic causes; and 5. strokes of unknown causes)
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