title: Thioredoxin is a novel diagnostic and prognostic marker in patients with ischemic stroke.
abstract: Serum thioredoxin (TRX), a redox-regulating protein with antioxidant activity, was recognized as an oxidative-stress marker. The purpose of this study was to investigate the potential diagnostic and prognostic role of TRX in Chinese patients with acute ischemic stroke (AIS). From January 1, 2012, to December 31, 2013, all patients with first-ever acute ischemic stroke were recruited to participate in the study. Serum levels of TRX were assayed with solid-phase sandwich ELISA, and severity of stroke was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score on admission. Short-term functional outcome was measured by a modified Rankin scale (mRS) 3 months after admission. Multivariate analyses were performed using logistic regression models. We found the serum TRX reflected the disease severity of AIS. There was a significant positive association between serum TRX levels and NIHSS scores (r= 0.476, P<0.0001). Based on the ROC curve, the optimal cutoff value of serum TRX levels as an indicator for auxiliary diagnosis of AIS was projected to be 11.0 ng/ml, which yielded a sensitivity of 80.3% and a specificity of 73.7%, with the area under the curve at 0.807 (95% CI, 0.766-0.847). Elevated TRX (≥ 20.0 ng/ml) was an independent prognostic marker of short-term functional outcome [odds ratio (OR) 9.482 (95% CI, 3.11-8.15) P<0.0001; adjusted for NIHSS, other predictors and vascular risk factors] in patients with AIS. TRX improved the area under the receiver operating characteristic curve of the NHISS score for functional outcome from 0.722 (95% CI, 0.662-0.782) to 0.905 (95% CI, 0.828-0.962; P<0.0001). Our study demonstrated that elevated serum TRX level at admission was a novel diagnostic and prognostic marker in patients with acute ischemic stroke.
authors.affiliation: Department of Neurology, The People׳s Hospital of Laiwu City, Laiwu, 271100, Shandong Province, People׳s Republic of China.
authors.forename: Ai-qin
authors.initials: AQ
authors.lastname: Qi
authors.affiliation: Department of Neurology, The People׳s Hospital of Laiwu City, Laiwu, 271100, Shandong Province, People׳s Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurology, The People׳s Hospital of Laiwu City, Laiwu, 271100, Shandong Province, People׳s Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Neurology, The People׳s Hospital of Laiwu City, Laiwu, 271100, Shandong Province, People׳s Republic of China.
authors.forename: Jun-Zeng
authors.initials: JZ
authors.lastname: Si
authors.affiliation: Department of Neurology, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, 100080, People׳s Republic of China.
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Laiwu People's Hospital, Laiwu, 271100, Shandong province, People's Republic of China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The People׳s Hospital of Laiwu City, Laiwu, 271100, Shandong Province, People׳s Republic of China.
authors.forename: Qin-De
authors.initials: QD
authors.lastname: Qi
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People׳s Republic of China. Electronic address: cmuneu698@163.com.
authors.forename: Wei-Bi
authors.initials: WB
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D013879:Thioredoxins / Q000097:blood*
chemical_list: D015415:Biomarkers; C491203:TXN protein, human; D013879:Thioredoxins
keywords: Acute ischemic stroke; Chinese; Diagnostic; Prognostic; Thioredoxin