Relationship of Serum Neutrophil Gelatinase-associated Lipocalin Levels with Stroke Attack and Renal Dysfunction in Patients / 现代检验医学杂志

ABSTRACT

Objective To explore the correlations of neutrophil gelatinase associated lipocalin (NGAL) with cerebral stroke attack and renal dysfunction of patients.Methods 63 patients with first-diagnosed hemorrhagic stroke (HS),233 patients with first diagnosed ischemic stroke (IS) and 293 healthy controls were randomly selected.Their age,gender and clinical his tory of hypertension,diabetes,coronary heart disease and hyperuricemia were recorded at admission,and their serum levels of kidney function/injury biomarkers (NGAL,Cr,Urea,CysC and eGFR) were measured at the next day.According to KDIGO guidelines standards,all subjects were divided into four groups on behalf of their renal damage degreeAKI,CKD,transient or no kidney injury,and control group.And then,the relations of these indicators with stroke attack and renal function of HS and IS patients were analyzed.Results The medians of serum NGAL levels in the patients with HS and IS were 160.0 and 142.9 μg/L,their difference had no statistical significance (Z=2.332,P＞0.05),but were higher than healthy controls (Z =12.621,9.189,all P＜0.05).The levels of serum NGAL in AKI,CKD,transient or no renal dysfunction,and control groups were 375.3,228.6,141.6 and 103.8 μg/L respectively,which had statistically significant differences between each other (Z=3.661～11.237,all P＜0.05).NGAL level was positively related to HS attack (rp=0.423,P＜0.001),IS attack (rp =0.231,P＜0.001) and renal dysfunction in both HS and IS patients (rp=0.429,0.289,all P＜0.001).Its partial cor relation coefficient was only lower than hypertension within HS stroke attack,and lower than coronary heart disease and diabetes within IS stroke attack,but the highest within renal function of either HS or IS patients.For assessing HS and IS attack,NGAL levels play a limited role (OR=1.044,0.974,allP＜0.001),in contrary to NGAL abnormity (OR =27.841,15.411,all P＜0.001).Conclusion Elevated NGAL levels may be a risk factor for stroke,suggesting that kidney injury or renal dysfunction may be associated with stroke,and the prevention and treatment of stroke should pay attention to the change of NGAL.