Key result
Higher baseline PON1 activity is linked to ~44% lower risk of poor ischemic stroke outcomes.
Why the study?
Although reduced PON1 activity is reported in acute ischemic stroke, the prognostic value of PON1 in AIS has not been clearly established.
Does higher baseline serum PON1 activity predict better 3-month functional outcomes in patients with acute ischemic stroke?
Cohort (n=336)
No
Does higher baseline serum PON1 activity predict better 3-month functional outcomes in patients with acute ischemic stroke?
Higher baseline serum PON1 activity is independently associated with better 3-month functional outcomes in patients with acute ischemic stroke, suggesting its potential as a prognostic biomarker.
Does not support routine PON1 testing in acute ischemic stroke; hypothesis-generating for its role as a prognostic biomarker.
Objective . Paraoxonase 1 (PON1) is an antioxidant enzyme, which has been proved to be involved in the pathophysiological process of oxidative stress and various neurological diseases in recent years. Although reduced PON1 activity has been reported in patients with acute ischemic stroke (AIS), the prognostic value of PON1 in AIS has not been clearly established. The purpose of this study was to determine whether the baseline serum PON1 activity level is related to the functional outcome of AIS patients. Methods . From July 2017 to June 2020, AIS patients within 3 days of symptom onset were continuously prospectively included in the study. On admission, clinical and laboratory data were recorded, and serum PON1 activity was tested. The National Institute of Health Stroke Scale (NIHSS) score was used to evaluate the initial neurologic deficit at admission, and the modified Rankin scale (mRS) was used to evaluate the functional outcome at 3 months. A multiple logistic regression model was used to analyze the relationship between the baseline PON1 activity level and the prognosis of AIS. Results . A total of 336 AIS patients were finally included in this study. The serum PON1 activity of AIS patients with good outcomes was significantly higher than that of patients with poor outcomes (193.4 ± 16.3 U/mL vs. 127.2 ± 14.9 U/mL, p < 0.001). However, the comparison of other clinical and laboratory data between AIS patients with good and poor outcomes was not significant ( p > 0.05). There was a significant decrease in the mRS score in patients with AIS across serum PON1 quartiles (3.0 ± 1.6, 2.6 ± 1.5, 2.4 ± 1.4, and 2.4 ± 1.3, p = 0.007). Multivariate logistic regression analysis showed that the 3‐month functional outcome of AIS patients was significantly correlated with the quartile of serum PON1 activity. Conclusions . This study suggests that the serum PON1 activity may be an independent predictor of the functional outcome of AIS patients.
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Xu et al. (2021) conducted a cohort in Acute Ischemic Stroke (AIS) (n=336). Serum PON1 activity vs. Lowest quartile of serum PON1 activity (Q1) was evaluated on Functional outcome at 3 months (mRS score) (OR 0.556, 95% CI 0.397-0.852, p=0.004). Higher baseline serum PON1 activity (highest vs lowest quartile) was independently associated with a better 3-month functional prognosis in patients with acute ischemic stroke (OR 0.556).
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