The serum levels and clinical significance of ferroptosis markers in patients with aneurysmal subarachnoid hemorrhage who underwent aneurysm clipping surgery

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-26 DOI:10.1016/j.jstrokecerebrovasdis.2025.108440

Xiaoli Wu, Xiqi Hu, Ying Xia, Bo Wang

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引用次数: 0

Abstract

Objective

This study aimed to explore the association between ferroptosis markers and postoperative prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH) who underwent aneurysm clipping. Specifically, we evaluated the predictive value of ferroptosis markers in determining post-operative outcomes.

Methods

We conducted a prospective observational study involving 210 aSAH patients who underwent aneurysm clipping surgery at our institution from October 2021 to May 2023. Blood samples were collected at postoperative days 1, 3, 7, and 30 to assess the levels of ferroptosis markers (ACSL4, SLC7A11, GPX4) and inflammatory cytokines (CRP, IL-6, TNF-α) using enzyme-linked immunosorbent assay (ELISA). Clinical data were recorded at baseline. Postoperative prognosis was assessed using the modified Rankin Scale (mRS) at 30 days post-surgery. All patients included in the study underwent aneurysm clipping surgery as their primary treatment modality.

Results

The serum levels of ACSL4 and IL-6 were significantly higher in the mRS 3-6 group compared to the mRS 0-2 group at all time points. In contrast, SLC7A11 and GPX4 levels were significantly lower in the mRS 3-6 group. Spearman’s correlation analysis revealed a significant negative correlation between ACSL4 and GPX4 and a positive correlation between ACSL4 and IL-6 levels. ROC curve analysis demonstrated that ACSL4 had the highest predictive value for poor postoperative prognosis, with an area under the curve (AUC) of 0.757. Multivariate logistic regression analysis identified aneurysm size, GCS, SLC7A11, ACSL4, GPX4, and IL-6 as independent risk factors for poor postoperative prognosis.

Conclusion

Serum ferroptosis markers, particularly ACSL4, along with inflammatory markers, have significant potential in predicting the postoperative prognosis of aSAH patients. These markers could serve as useful biomarkers for early risk stratification and clinical decision-making in aSAH management.

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动脉瘤夹闭术后动脉瘤性蛛网膜下腔出血患者血清上下垂铁标志物水平及临床意义。

目的：本研究旨在探讨动脉瘤性蛛网膜下腔出血（aSAH）患者行动脉瘤夹闭术后下垂铁标志物与术后预后的关系。具体来说，我们评估了铁下垂标志物在确定术后预后方面的预测价值。方法：我们进行了一项前瞻性观察研究，纳入了2021年10月至2023年5月在我院接受动脉瘤夹闭手术的210例aSAH患者。术后第1、3、7和30天采集血样，采用酶联免疫吸附试验（ELISA）评估铁下垂标志物（ACSL4、SLC7A11、GPX4）和炎症因子（CRP、IL-6、TNF-α）水平。基线时记录临床资料。术后30天采用改良Rankin评分（mRS）评估术后预后。所有纳入研究的患者均以动脉瘤夹闭手术作为主要治疗方式。结果：mRS 3 ~ 6组血清ACSL4、IL-6水平在各时间点均明显高于mRS 0 ~ 2组。mRS 3-6组SLC7A11和GPX4水平明显降低。Spearman相关分析显示ACSL4与GPX4呈显著负相关，而ACSL4与IL-6呈正相关。ROC曲线分析显示，ACSL4对术后不良预后的预测价值最高，曲线下面积（AUC）为0.757。多因素logistic回归分析发现动脉瘤大小、GCS、SLC7A11、ACSL4、GPX4、IL-6是术后不良预后的独立危险因素。结论：血清铁下垂标志物，尤其是ACSL4与炎症标志物对预测aSAH患者术后预后具有重要意义。这些标志物可作为aSAH早期风险分层和临床决策的有用生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.