Neuropsychiatric Disease and Treatment (Sep 2022)

Plasma SIRT3 as a Biomarker of Severity and Prognosis After Acute Intracerebral Hemorrhage: A Prospective Cohort Study

  • Yan T,
  • Wang ZF,
  • Wu XY,
  • Du Q,
  • Yu WH,
  • Hu W,
  • Zheng YK,
  • Wang KY,
  • Dong XQ

Journal volume & issue
Vol. Volume 18
pp. 2199 – 2210

Abstract

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Tian Yan,1 Ze-Fan Wang,1 Xiao-Yu Wu,1 Quan Du,2 Wen-Hua Yu,2 Wei Hu,3 Yong-Ke Zheng,3 Ke-Yi Wang,4 Xiao-Qiao Dong2 1The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China; 2Department of Neurosurgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 3Department of Intensive Care Unit, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 4Clinical Laboratory Center, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of ChinaCorrespondence: Xiao-Qiao Dong, Department of Neurosurgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China, Email [email protected]: SIRT3 may act as a brain-protective factor. We measured the plasma SIRT3 levels of patients with intracerebral hemorrhage (ICH) and further determined the relationship between plasma SIRT3 and clinical outcome plus severity of ICH.Methods: In this prospective cohort study, we quantified plasma SIRT3 levels in 105 ICH patients and 72 healthy controls. Glasgow Coma Scale (GCS) score and hematoma volume were used to assess severity. Poor prognosis was defined as a Glasgow Outcome Scale (GOS) score of 1– 3 at 90 days after ICH.Results: Plasma SIRT3 levels were markedly lower in patients than in controls (median, 10.19 versus 13.17 ng/mL; P< 0.001). Among all patients, plasma SIRT3 levels were independently correlated with hematoma volume (beta, − 0.098; 95% confidence interval, − 0.158--0.039; t, − 3.282; P=0.001) and GCS score (beta, 0.465; 95% confidence interval, 0.107– 0.823; t, 2.576; P=0.011). A total of 46 cases had a poor prognosis at post-stroke 90 days. The plasma levels of SIRT3 significantly decreased in patients with a poor prognosis, compared with those with a good prognosis (median, 6.1 versus 11.2 ng/mL; P< 0.001). Plasma SIRT3 was an independent predictor for 90-day poor prognosis of patients (odds ratio, 0.837; 95% confidence interval, 0.708– 0.990; P=0.038). Plasma SIRT3 levels distinguished the development of poor prognosis with area under receiver operating characteristic curve at 0.801 (95% confidence interval, 0.711– 0.872) and plasma SIRT3 levels ≤ 7.38 ng/mL predicted poor prognosis with 63.04% sensitivity and 93.22% specificity.Conclusion: Declined plasma SIRT3 levels are highly associated with hemorrhagic severity and poor 90-day outcome, thus suggesting that plasma SIRT3 may serve as a potential prognostic biomarker for ICH.Keywords: intracerebral hemorrhage, prognosis, severity, SIRT3, outcome

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