The Impact of Plasma Homocysteine Level and Estimated Glomerular Filtration Rate on Neurological Function at Admission in Patients with Acute Ischemic Stroke: A Retrospective Cross-Sectional Study

Aijun Quan,1 Sihui Guo,1 Ying Jiang,1 Wei Wei,2 Minna Jiao,1 Xinxin Yue,1 Manchao Sun,1 Lu Lang,1 Mengxue Bao,1 Lili Shang3,4 1Department of Critical Care Rehabilitation/Department of Critical Care Medicine, the Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150036, People’s Republic of China; 2Department of Radiology, the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150036, People’s Republic of China; 3Department of Nephrology, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, 100038, People’s Republic of China; 4Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150036, People’s Republic of ChinaCorrespondence: Lili Shang, Email [email protected]: To investigate the effects of homocysteine (Hcy) and estimated glomerular filtration rate (eGFR) on neurological function in patients with ischemic stroke (IS) on admission.Methods: 248 IS patients admitted to the Third Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2023 to January 2025 were studied. Basic information, disease history, laboratory test indicators and other information of patients were recorded at admission. According to admission mRS scores, patients were divided into two groups: the control group with good neurological function (mRS 0– 1) and the neurological dysfunction group (mRS 2– 5). The relationship between Hcy and eGFR on the neurological function of IS patients at admission was analyzed using a multivariate logistic regression model and an additive interaction model.Results: Among 248 patients, there were 118 patients with neurological dysfunction and 130 patients with good neurological function. After adjusting for confounding factors, it was found that eGFR and Hcy were independent influencing factors of neurological function in IS patients on admission (P < 0.05). The risk of neurological dysfunction in patients with elevated Hcy and decreased eGFR on admission was 4.28 times higher than that in patients with both indicators normal [OR = 4.28 (95% CI2.62– 7.24), P < 0.001)]. There was a significant negative correlation between HCY and eGFR, and Hcy and eGFR had an additive interaction effect on the risk of neurological dysfunction on admission (RERI = 2.02, 95% CI0.02– 4.01; AP = 0.45, 95% CI0.13– 0.79).Conclusion: Hcy and eGFR are the influencing factors of neurological dysfunction in IS patients, and the two are significantly negatively correlated with the risk of neurological dysfunction in IS patients, and there is an additive interaction.Keywords: ischemic stroke, homocysteine, glomerular filtration rate, neurological function recovery