RVD2 emerges as a serological marker in relation to severity and six-month clinical outcome following acute intracerebral hemorrhage: A prospective cohort study from a single academic institution.
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Abstract
Background: Resolvin D2 (RvD2), with an anti-inflammatory activity, harbors a neuroprotective property. Here, serum RvD2 levels were detected with an attempt to explore its prognostic implication in human acute intracerebral hemorrhage (ICH).
Methods: In this prospective cohort study, serum RvD2 levels of 301 ICH patients, coupled with 100 heathy individuals, were gauged. All patients were randomly divided to two groups (200 patients in the study group and 101 in the validation group) in a 2:1 ratio. Change of serum RvD2 levels after ICH was investigated, and its correlations with National Institutes of Health Stroke Scale (NIHSS) scores, hematoma volume and poststroke six-month modified Rankin Scale (mRS) scores were determined using multivariate analysis. Its independent association with poor prognosis (mRS scores of 3-6) was uncovered in the study group and its prognostic predictive value was verified in the validation group.
Results: The serum levels of RvD2 in patients displayed a notable decline upon admission, as compared to controls. The levels exhibited independent correlations with NIHSS scores, hematoma size and mRS scores. Alternatively, RvD2 levels had independent relation to a poor prognosis after ICH. Within the framework of restricted cubic spline analysis, RvD2 levels were linearly correlated with the likelihood of poor prognosis, even adjusting for NIHSS scores and hematoma size. In the context of receiver operating characteristic (ROC) curve analysis, serum RvD2 dramatically distinguished risk of poor prognosis, with similar predictive ability to NIHSS scores and hematoma volume. By employing subgroup analysis, the relationship between RvD2 levels and poor prognosis was not obviously influenced by other parameters, such as age, sex, hypertension, and more. The integrated model containing serum RvD2, NIHSS scores and hematoma volume was visualized on a nomogram and showed high predictive performance and clinical effectiveness for poor prognosis via multiple evaluation metrics, including the Hosmer-Lemeshow test, ROC curve analysis, calibration curve analysis and decision curve analysis. Clinical usefulness of serum RvD2 was verified in the validation group.
Conclusion: Serum RvD2 levels exhibit an immediate decrease post-ICH, which could be able to accurately reflect ICH severity and efficiently prognosticate poor neurological outcomes, signifying that serum RvD2 may represent an encouraging prognostic indicator in ICH.
期刊介绍：
The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells.
The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.
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