Progranulin and short-term outcome in patients with acute ischaemic stroke

Stroke is a leading cause of death and severe disability worldwide. Serum biomarkers play a critical role in the assessment of the severity and prognosis in stroke patients.

In this prospective cohort study, the measurement of serum progranulin (PGRN) was conducted in 316 participants, including 216 patients with an identified diagnosis of acute ischaemic stroke and 100 normal control subjects. The primary end-point was defined as all-cause mortality for a short-term follow-up of 6 months. Adverse functional outcome (modified Rankin Scale score ≥3) was considered as the secondary end-point.

The median value of serum PGRN for patients with acute ischaemic stroke was 64.2 ng/ml (interquartile range 54.6-73.7), which was significantly higher than the control group [59.7 (54.4-64.4) ng/ml; P < 0.001]. Multivariable linear regression suggested that PGRN levels were significantly correlated with body mass index, alcohol consumption, fasting blood glucose, total cholesterol, National Institutes of Health Stroke Scale (NIHSS) score and high-density lipoprotein cholesterol. Serum PGRN concentrations were independently associated with increased risks of all-cause mortality and adverse functional outcome after adjustment for clinical variables. In Cox proportional hazards models, PGRN levels were associated with the risk of mortality (hazard ratio 1.090, 95% confidence interval 1.033-1.150, P = 0.002). The net reclassification improvement of the model with added PGRN was 0.1902 (P = 0.0234) after adjustment for the variables in the Cox regression model for predicting all-cause mortality, and the integrated discrimination improvement was 0.1052 (P < 0.001).

Serum PGRN levels independently predicted all-cause mortality and adverse functional outcome in the short term in stroke patients. The discriminative power was improved by PGRN on the basis of NIHSS score.