The relationship between serum HOXA1 and SMAD3 mRNA expression,cognitive function,and prognosis in pa-tients with vascular dementia caused by ischemic stroke
Objective To explore the relationship between serum homologous box gene A1(HOXA1)and SMAD family member 3(SMAD3)mRNA expression,cognitive function,and prognosis in patients with vascular dementia(VD)in-duced by ischemic stroke.Methods Two hundred and forty-one patients with ischemic stroke admitted to the Neurology Department of Jinqiu Hospital in Liaoning Province from January 2021 to February 2023 were selected as the research sub-jects.They were divided into dementia group(n=117)and non dementia group(n=124)based on whether VD occurred 3 months later.According to the prognosis of functional impairment three months after discharge,dementia patients were di-vided into grade Ⅰ subgroup(n=48),grade Ⅱ subgroup(n=43),and grade Ⅲ subgroup(n=26).Spearman correlation anal-ysis of the correlation between serum HOXA1 and SMAD3 mRNA expression in patients with ischemic stroke induced VD and the Mini Mental State Scale(MMSE)score;The predictive value of receiver operating characteristic(ROC)curve analy-sis of serum HOXA1 and SMAD3 mRNA expression for predicting grade Ⅲ functional impairment in patients with ischemic stroke induced VD.Results Compared with the non dementia group,the serum mRNA expression of HOXA1 and SMAD3 in the dementia group were significantly increased(t=30.176,16.855,P<0.001);The mRNA expression of serum HOXA1 and SMAD3 in the mild,moderate,and severe subgroups increased sequentially,and the differences were statistically signif-icant(F=308.625,153.360,P<0.001);Compared with the subgroups of grade Ⅰ to Ⅱ with prognostic dysfunction,the serum mRNA expression of HOXA1 and SMAD3 in the grade Ⅲ subgroup patients were significantly increased(t=8.274,9.396,P<0.01);The Spearman correlation analysis results showed that the serum mRNA expression of HOXA1 and SMAD3 in pa-tients with ischemic stroke induced VD were significantly negatively correlated with MMSE scores(r=-0.564,-0.518,P<0.01);The AUC of serum HOXA1,SMAD3,and their combined prediction of grade Ⅲ prognostic dysfunction in patients with ischemic stroke induced VD were 0.772,0.831,and 0.899,respectively.The combined AUC of the two was greater than the single indicator(Z/P=2.001/0.045,2.116/0.034).Conclusion HOXA1 and SMAD3 are closely related to cognitive func-tion and prognosis in VD patients caused by ischemic stroke,and serum mRNA expression of HOXA1 and SMAD3 have high application value in predicting prognostic dysfunction in VD patients caused by ischemic stroke.
Ischemic strokeVascular dementiaCognitive functionHomologous box gene A1SMAD family member 3
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