Diagnostic value of sclerostin, RANKL, oxidized LDL, and phoenixin-14 levels in acute ischemic stroke

Acute ischemic stroke (AIS) is a leading cause of mortality and morbidity, yet largely preventable. An urgent clinical need exists for new biomarkers that enable early, noninvasive, and accurate diagnosis, even before the incident occurs. This study aims to determine the valency of serum sclerostin (SOST), receptor activator of nuclear factor-kappa B ligand (RANKL), oxidized low-density lipoproteins (OxLDL), and phoenixin-14 in AIS.

A case-control study was conducted in the emergency department (ED) of a tertiary care hospital between June 2024 and September 2024, including 48 patients with AIS and 40 healthy individuals. The enzyme-linked immunosorbent assay was used to determine the levels of SOST, OxLDL, RANKL, and phoenixin-14. Diagnostic accuracy and independent associations with AIS were examined.

Biomarker levels were significantly higher in AIS group. SOST was the best, with an area under the curve of 0.809. A one-unit increase in SOST and OxLDL levels increased the probability of stroke by 1.418 and 1.006 times, respectively.

SOST, OxLDL, RANKL, and phoenixin-14 May be complementary markers that warrant further validation, even though the results show an association rather than a causal relationship, suggesting they might be useful for differentiating AIS from healthy controls.