Abstract
BACKGROUND: Acute ischemic stroke (AIS) ranks among the most prevalent cerebrovascular conditions. The clinical interest lies in utilizing oxidative stress (OS) markers and antioxidant system indicators for diagnosing and predicting stroke development. Our objective was to identify a precise marker of antioxidant stress ability to assess neurofunctional alterations in AIS patients. METHODS: A total of 66 AIS patients, 33 of whom also had type 2 diabetes mellitus (T2DM), were selected for our study, and 30 patients without AIS and diabetes were used as controls. The total plasma homocysteine (Hcy) concentrations were determined via an enzymatic cycling assay. The reduced Hcy to oxidised Hcy concentration ratio (Hcy/HHcy) was determined using hollow fibre centrifugal ultrafiltration (HFCF-UF) technique we previously established. RESULTS: The Hcy/HHcy was significantly lower in AIS patients with T2DM compared with both controls (P = 0.0262) and AIS patients without T2DM (P = 0.0468). A positive correlation was found between total Hcy concentration and the National Institutes of Health Stroke Scale (NIHSS) score (P = 0.002, r = 0.561), while no correlation was observed in AIS patients without T2DM (P = 0.850, r=-0.034). In AIS patients, the Hcy/HHcy showed a positive correlation with the NIHSS score in those with T2DM (P = 0.037, r = 0.365) and a negative correlation in those without T2DM (P = 0.003, r=-0.497). In AIS patients with T2DM, the receiver operating characteristic's area under the curve (ROC-AUC) value for total Hcy concentration was 0.796, compared to 0.600 in those without T2DM. Furthermore, the ROC-AUC values of the Hcy/HHcy were 0.719 and 0.735 in AIS patients with and without T2DM, respectively. CONCLUSION: Hcy/HHcy is anticipated to serve as a precise indicator for assessing antioxidant stress ability and evaluating neurofunctional alterations in AIS patients.