title: Correlation of Plasma Vascular Endothelial Growth Factor and Endostatin Levels with Symptomatic Intra- and Extracranial Atherosclerotic Stenosis in a Chinese Han Population.
abstract: BACKGROUND
  Symptomatic intracranial atherosclerotic stenosis (ICAS) and extracranial atherosclerotic stenosis (ECAS) are different in many aspects. Here, we explored the association between the location or severity of atherosclerotic stenosis and pro- or antiangiogenic factors, specifically vascular endothelial growth factor (VEGF) and endostatin (ES).
  
  
  METHODS
  We evaluated 198 consecutive patients with acute ischemia stroke: 132 with large-artery atherosclerosis (LAA) and 66 with small-artery occlusion (small-vessel occlusion). The LAA group was subclassified into 102 patients with ICAS and 30 with ECAS. Independent associations of VEGF, ES levels, and VEGF/ES ratio with the location of cerebral stenosis and the severity or short-term prognosis (14th day modified Rankin Scale) of ICAS were evaluated.
  
  
  RESULTS
  Plasma concentrations of VEGF and ES were lower (P < .05) in ICAS (38.07, 32.76-46.28 pg/mL and 58.95, 55.04-59.77 ng/mL) than those in ECAS (45.00, 34.30-83.34 pg/mL and 140.74, 85.63-231.21 ng/mL). Logistic regression analysis showed that VEGF concentrations and dyslipidemia were independently associated with ICAS, with odds ratios of .987 [95% CI = (.976, .998)] and .265 [95% CI = (.103, .792)], respectively. Moreover, plasmatic VEGF levels increased gradually along with the severity of ICAS (P = .003), and lower levels of ES (P = .040) or a higher VEGF/ES ratio (P = .048) were related to unfavorable short-term prognosis of ICAS.
  
  
  CONCLUSIONS
  Lower VEGF levels are associated with the presence of symptomatic ICAS, but not with ECAS. Furthermore, the severity of ICAS is positively correlated with the levels of VEGF, and lower ES levels or a predominance of VEGF over ES are predictors of poor short-term prognosis of ICAS.
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Sian
authors.initials: S
authors.lastname: Zeng
authors.affiliation: Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhan
authors.affiliation: Department of Neurology, Second Affiliated Hospital, University of South China, Hengyang, Hunan, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Yuan
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
authors.forename: Qidong
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: xiajian1216@sina.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Xia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D016893:Carotid Stenosis / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D059345:Cerebral Small Vessel Diseases / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D016009:Chi-Square Distribution; D002681:China; D004185:Disability Evaluation; D043169:Endostatins / Q000097:blood*; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D015415:Biomarkers; D043169:Endostatins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Symptomatic intracranial atherosclerotic stenosis disease; angiogenesis; endostatin; risk factors; short-term prognosis; symptomatic extracranial atherosclerotic stenosis disease; vascular endothelial growth factor