Correlation Analysis Between High‐Density Lipoprotein Cholesterol‐Carried microRNA‐28‐5p and Acute Ischemic Stroke

ABSTRACT This paper aimed to disclose the correlation of high‐density lipoprotein cholesterol (HDL‐C)‐carried microRNA‐28‐5p (miR‐28‐5p) with acute ischemic stroke (AIS). This study retrospectively included 216 first‐diagnosed AIS patients (study subjects) and 102 healthy people (controls). Clinical data, serum total cholesterol (TC), triglycerides (TG), glucose, homocysteine (Hcy), HDL‐C, low‐DL‐C (LDL‐C), interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), high‐sensitivity C‐reactive protein (hs‐CRP), and fasting serum samples were collected. Serum miR‐28‐5p levels and disease severity were assessed by RT‐qPCR and National Institutes of Health Stroke Scale (NIHSS). The diagnostic efficacy of miR‐28‐5p and Hcy for AIS and disease severity was evaluated using ROC curves. miR‐28‐5p was upregulated in AIS patients, positively correlated with HDL‐C ( p < 0.001, r = 0.848), and negatively correlated with TC ( p < 0.001, r = 0.673). HDL‐C‐carried miR‐28‐5p was an independent influencing factor for AIS ( p = 0.027, OR = 1.294, 95% CI = 1.030–1.626) and helped diagnose AIS (AUC = 0.938, 95% CI = 0.912–0.963). miR‐28‐5p was positively correlated with NIHSS scores ( p < 0.001, r = 0.777) in AIS patients, and provided diagnostic value for AIS (positive predictive value [PPV] = 96.907%, negative predictive value [NPV] = 77.419%) and AIS severity (PPV = 95.200%, NPV = 75.824%). PPV > 95% and NPV < 90% suggested that miR‐28‐5p offered auxiliary diagnostic value for AIS and its severity, with limited diagnostic accuracy, and there might be a relatively high risk of missed diagnosis. The combination of miR‐28‐5p and Hcy improved the diagnostic value of miR‐28‐5p alone for AIS and its severity. Collectively, HDL‐C‐carried miR‐28‐5p is highly expressed in AIS patients and positively correlated with NIHSS score. It is an independent influencing factor for AIS and may assist in diagnosing AIS and its severity. Additionally, miR‐28‐5p combined with Hcy can increase the diagnostic value of miR‐28‐5p single detection for AIS and its severity. image