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Association of Serum Fetuin-B with Large-Artery Atherosclerotic Acute Ischemic Stroke and Functional Outcome
Xunwei Deng1,2,3, Ting Hu1, Kunyuan Zhou4
1Meizhou Clinical Institute, Shantou University Medical College, Meizhou, Guangdong, People's Republic of China.
Objective:
This study investigated the association of serum fetuin-B with large-artery atherosclerotic acute ischemic stroke (LAA-AIS) and poor functional outcome after stroke.
Methods:
We retrospectively enrolled 216 consecutive LAA-AIS patients from September 2023 to December 2024 and 194 age- and sex-matched healthy controls. Serum fetuin-B was measured via ELISA. Multivariable logistic regression and restricted cubic spline (RCS) analyses were used to assess the relationships between fetuin-B and the presence of LAA-AIS or poor functional outcome (modified Rankin Scale > 2). Predictive performance was evaluated using C-index, net reclassification index (NRI), integrated discrimination improvement (IDI), calibration plots, and decision curve analysis (DCA). Internal validation was performed via 1000 bootstrap resamples.
Results:
Serum fetuin-B was significantly higher in patients with LAA-AIS than in controls (2.68 vs 1.79 µg/mL, P < 0.001) and correlated positively with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), and C-reactive protein (CRP). Multivariable regression showed higher fetuin-B independently associated with the presence of LAA-AIS (OR = 2.433, P < 0.001) and poor functional outcome (OR = 1.903, P < 0.001). Fetuin-B tertiles showed a graded increase in both risks (all P for trend <0.05). Incorporating fetuin-B to the basic model significantly improved the C-index for LAA-AIS risk (from 0.827 to 0.871) and poor functional outcome (from 0.749 to 0.806), supported by significant NRI and IDI (all P < 0.01). Calibration curves and DCA indicated good consistency and clinical net benefit. RCS analysis further revealed a non-linear association between fetuin-B and the presence of LAA-AIS, as well as an approximately linear association with poor functional outcome.
Conclusion:
Elevated serum fetuin-B measured after stroke onset was independently associated with LAA-AIS status and poor functional outcome.
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