VALUE OF SERUM LP-PLA2, ADAMTS4 AND FGF23 IN EVALUATING THE STABILITY OF CAROTID PLAQUE

Huihua Shi, Xiaoyu Wu, Xin Wang, Chaoyi Cui, Xinrui Yang^*

Department of Vascular Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Shanghai, PR China

Objective: The objective is to investigate the value of Lp-PLA2, ADAMTS4, and FGF23 serum in evaluating the stability of carotid plaque.

Methods: From August 2018 to August 2019, 64 patients with carotid stenosis were admitted to our hospital and enrolled. According to the pathological tissue types, the patients were divided into a stable plaque group (n = 34) and an unstable plaque group (n = 30). The patients who were selected for physical examination in our hospital during the same time were the control group (n = 30). The levels of Lp-PLA2, ADAMTS4, and FGF23 serum in each group were detected using an enzyme-linked immunosorbent assay. The Lp-PLA2, ADAMTS4, and FGF23 serum levels were analysed using the receiver operating characteristic (ROC) curve analysis to evaluate the value of the carotid plaque stability.

Results: The Lp-PLA2, ADAMTS4, FGF23, IL-6, and hs-CRP serum levels were significantly higher in the unstable plaque group than in the stable plaque group and control group. The Lp-PLA2, ADAMTS4, FGF23, IL-6, and hs-CRP levels in the stable plaque group were significantly higher than those in the control group, and the difference was statistically significant (P<.01). In the stable plaque group, the neovascular grading was primarily Grades I and II, accounting for 67.65%. The unstable plaque group was primarily Grades III and IV, accounting for 70.00%. Significant differences were found in the grades of neovascularisation between the two groups (P<.05). A multivariate logistic regression analysis showed that Lp-PLA2, ADAMTS4, FGF23, IL-6, and hs-CRP levels are independent risk factors for carotid plaque stability (P<.05). Using the ROC curve analysis, the area under the curve (AUC) for the Lp-PLA2 evaluation of carotid plaque stability was 0.952. The optimal cutoff value was 134.26 μg/L. The sensitivity was 82.45%, and the specificity was 76.49%. The stability of the carotid plaque was evaluated using ADAMTS4 with an AUC of 0.931, with an optimal cutoff value of 98.26 ng/mL. The sensitivity was 79.58%, and specificity was 85.61%. The stability of carotid plaque evaluated using FUC23 showed an AUC of 0.915. The cutoff value was 55.79 pg/mL. The sensitivity was 81.64%, and the specificity was 76.48%.

Conclusion: The Lp-PLA2, ADAMTS4, and FGF23 levels have a certain value in evaluating the stability of carotid plaque and can be widely used in the clinic.