Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke
Background We aimed to examine the relationship between serum FGF20 (fibroblast growth factor 20) levels and stroke prognosis in a multicenter cohort study. Methods and Results Patients with ischemic stroke/transient ischemic attack were prospectively recruited from 5 participating centers and follo...
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Wiley
2024-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.036721 |
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| author | Keyang Chen Wenting Huang Beilei Hu Fangwang Fu Yungang Cao Huiqin Xu Lixin Ruan Yongang Li Yan Li Jun Chen Fei Liang Xue Wang Xudong Du Li Lin Xiaokun Li |
| author_facet | Keyang Chen Wenting Huang Beilei Hu Fangwang Fu Yungang Cao Huiqin Xu Lixin Ruan Yongang Li Yan Li Jun Chen Fei Liang Xue Wang Xudong Du Li Lin Xiaokun Li |
| author_sort | Keyang Chen |
| collection | DOAJ |
| description | Background We aimed to examine the relationship between serum FGF20 (fibroblast growth factor 20) levels and stroke prognosis in a multicenter cohort study. Methods and Results Patients with ischemic stroke/transient ischemic attack were prospectively recruited from 5 participating centers and followed up at 3 months and 1 year. FGF20 levels were measured using the ELISA method. The primary outcome was poor stroke functional outcome (modified Rankin Scale score of 3–6), and secondary outcomes included death and composite vascular events. Multivariable logistic regression analysis or Cox proportional hazards regression analysis was employed to estimate the relationship between FGF20 and study outcomes. Mediation analysis was conducted to examine the mediating effects of traditional risk factors on the association between FGF20 and stroke outcomes. A total of 1011 patients with ischemic stroke were included in the study. After adjusting for potential confounding factors, an elevated serum FGF20 level was associated with a reduced risk of the poor outcome and death. Multivariable adjusted spline regression analysis demonstrated a linear correlation between serum FGF20 levels and the stroke outcomes. The incorporation of FGF20 alongside conventional risk factors marginally enhanced the reclassification of adverse outcomes. Renal function and white blood cell count partially mediated the relationship between FGF20 and the prognosis of ischemic stroke. Conclusions Elevated FGF20 level is associated with decreased risks of adverse outcomes after ischemic stroke, which was partially mediated by renal function and white blood cells with a modest amount, indicating that serum FGF20 might serve as a promising biomarker for predicting stroke prognosis. Registration URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2100051104. |
| format | Article |
| id | doaj-art-bd10ab3e88424f39893fa74c53a59415 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-bd10ab3e88424f39893fa74c53a594152025-08-20T02:38:26ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-12-01132310.1161/JAHA.124.036721Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic StrokeKeyang Chen0Wenting Huang1Beilei Hu2Fangwang Fu3Yungang Cao4Huiqin Xu5Lixin Ruan6Yongang Li7Yan Li8Jun Chen9Fei Liang10Xue Wang11Xudong Du12Li Lin13Xiaokun Li14Department of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The First Affiliated Hospital Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The First Affiliated Hospital Hospital of Wenzhou Medical University Wenzhou ChinaThe People’s Hospital of Pingyang Wenzhou ChinaThe First People’s Hospital of Wenling Taizhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaSchool of Pharmaceutical Sciences Wenzhou Medical University Wenzhou ChinaSchool of Pharmaceutical Sciences Wenzhou Medical University Wenzhou ChinaSchool of Pharmaceutical Sciences Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaSchool of Pharmaceutical Sciences Wenzhou Medical University Wenzhou ChinaDepartment of Neurology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University Wenzhou ChinaBackground We aimed to examine the relationship between serum FGF20 (fibroblast growth factor 20) levels and stroke prognosis in a multicenter cohort study. Methods and Results Patients with ischemic stroke/transient ischemic attack were prospectively recruited from 5 participating centers and followed up at 3 months and 1 year. FGF20 levels were measured using the ELISA method. The primary outcome was poor stroke functional outcome (modified Rankin Scale score of 3–6), and secondary outcomes included death and composite vascular events. Multivariable logistic regression analysis or Cox proportional hazards regression analysis was employed to estimate the relationship between FGF20 and study outcomes. Mediation analysis was conducted to examine the mediating effects of traditional risk factors on the association between FGF20 and stroke outcomes. A total of 1011 patients with ischemic stroke were included in the study. After adjusting for potential confounding factors, an elevated serum FGF20 level was associated with a reduced risk of the poor outcome and death. Multivariable adjusted spline regression analysis demonstrated a linear correlation between serum FGF20 levels and the stroke outcomes. The incorporation of FGF20 alongside conventional risk factors marginally enhanced the reclassification of adverse outcomes. Renal function and white blood cell count partially mediated the relationship between FGF20 and the prognosis of ischemic stroke. Conclusions Elevated FGF20 level is associated with decreased risks of adverse outcomes after ischemic stroke, which was partially mediated by renal function and white blood cells with a modest amount, indicating that serum FGF20 might serve as a promising biomarker for predicting stroke prognosis. Registration URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2100051104.https://www.ahajournals.org/doi/10.1161/JAHA.124.036721fibroblast growth factor 20ischemic strokemediation analysisprognosis |
| spellingShingle | Keyang Chen Wenting Huang Beilei Hu Fangwang Fu Yungang Cao Huiqin Xu Lixin Ruan Yongang Li Yan Li Jun Chen Fei Liang Xue Wang Xudong Du Li Lin Xiaokun Li Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease fibroblast growth factor 20 ischemic stroke mediation analysis prognosis |
| title | Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke |
| title_full | Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke |
| title_fullStr | Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke |
| title_full_unstemmed | Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke |
| title_short | Mediation Analysis of Serum Fibroblast Growth Factor 20 and Poor Prognosis After Ischemic Stroke |
| title_sort | mediation analysis of serum fibroblast growth factor 20 and poor prognosis after ischemic stroke |
| topic | fibroblast growth factor 20 ischemic stroke mediation analysis prognosis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.036721 |
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