Neuropsychiatric Disease and Treatment (Jan 2022)
Elevated Serum Complement C1q Levels After Traumatic Brain Injury and Its Association with Poor Prognosis
Abstract
Xin-Jiang Yan,1 Yang-Bo Li,1 Wei Liu,1 Hua-Yong Wu,2 Guo-Feng Yu1 1Department of Neurosurgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, People’s Republic of China; 2Neurosurgical Intensive Care Unit, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, People’s Republic of ChinaCorrespondence: Guo-Feng Yu Tel +86 570 3055179Email [email protected]: Complement C1q is implicated in neuroinflammation. We intended to discern the relationship between serum C1q levels and severity in addition to prognosis following traumatic brain injury (TBI).Methods: In this prospective, observational study, serum C1q levels were quantified in 188 TBI patients and 188 healthy controls. Glasgow coma scale (GCS) and Rotterdam computed tomography (CT) classification were used as clinical and radiological indicators of severity. Patients with extended Glasgow outcome scale (GOSE) score of 1– 4 at 6 months after trauma were considered to have a poor outcome. Multiple logistic regression model was built to ascertain the independent association of serum C1q levels with 6-month poor outcome. Receiver operating characteristic (ROC) curve was configured for analysis of prognostic capability with respect to serum C1q levels.Results: TBI patients exhibited substantially higher serum C1q levels than controls (median, 223.9 mg/l versus 75.4 mg/l). Serum C1q levels of patients were tightly correlated with GCS score (r = − 0.671), Rotterdam CT classification (r = 0.604) and GOSE score (r = − 0.581). An area under the ROC curve was yielded of 0.793 (95% confidence interval = 0.728– 0.849), and serum C1q levels above 345.5 mg/l discriminated the risk of 6-month poor outcome with 59.6% sensitivity and 92.6% specificity. Serum C1q levels above 345.5 mg/l retained as an independent predictor for 6-month poor outcome with odds ratio of 4.922 (95% confidence interval = 1.552– 15.606; P = 0.017).Conclusion: Elevated serum C1q levels are closely correlated with traumatic severity and independently predicted the risk of long-term poor prognosis after TBI.Keywords: traumatic brain injury, C1q, severity, functional outcome, biomarkers
