arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2025-2483XIYRTKarthyper-2533Research ArticleСтатьиArticlesЛабораторные биомаркеры — предикторы прогноза исходов ишемического инсульта у пациентов с сахарным диабетом 2‑го типаLaboratory biomarkers — predictors of the prognosis of ischemic stroke outcomes in patients with type 2 diabetes mellitushttps://orcid.org/0000-0002-5918-7450ПетуховаО. В.PetukhovaOlga V.

Петухова Ольга Владимировна — врач-невролог,

Санкт-Петербург, Сестрорецк.

Olga V. Petukhova, MD, Neurologist,

Saint-Petersburg, Sestroretsk.

olya.petuchova84@mail.ruhttps://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskyStanislav N.

Янишевский Станислав Николаевич — доктор медицинских наук, заведующий научно-исследовательской лабораторией неврологии и нейрореабилитации, профессор кафедры неврологии с клиникой, 

Санкт-Петербург.

Stanislav N. Yanishevsky, MD, PhD, DSc, Head, Research Laboratory of Neurology and Neurorehabilitation, Professor of the Department of Neurology, 

Saint-Petersburg.

yanishevskiy_sn@almazovcentre.ruhttps://orcid.org/0000-0001-5047-2792ЩербакС. Г.ScherbakSergey G.

Щербак Сергей Григорьевич — доктор медицинских наук, профессор, главный врач; заведующий кафедрой последипломного медицинского образования медицинского факультета, 

Санкт-Петербург.

Sergey G. Scherbak, MD, PhD, DSc, Professor, Chief Physician; Head of Postgraduate Medical Education Chair, Medical Faculty, 

Saint-Petersburg.

sgsherbak@mail.ruhttps://orcid.org/0000-0003-3198-8990СаранаА. М.SaranaAndrey M.

Сарана Андрей Михайлович — кандидат медицинских наук, доцент кафедры последипломного медицинского образования, директор Медицинского института, 

Санкт-Петербург.

Andrey M. Sarana, MD, PhD, Associated Professor, Postgraduate Medical Education Chair, Director, Medical Institute, 

Saint-Petersburg.

asarana@mail.ruhttps://orcid.org/0000-0001-5642-621XАсиновскаяА. Ю.AsinovskayaAnna Yu.

Асиновская Анна Юрьевна — кандидат медицинских наук, врач-терапевт, заместитель главного врача по науке; старший научный сотрудник, доцент кафедры последипломного медицинского образования медицинского факультета,

Санкт-Петербург.

Anna Yu.  Asinovskaya, MD, PhD, Physician, Deputy Chief Physician for Science; Senior Researcher, Associated Professor, Postgraduate Medical Education Department, Medical Faculty, 

Saint-Petersburg.

anna_anisenkova@list.ruhttps://orcid.org/0000-0002-1595-6668МакаренкоС. В.MakarenkoStanislav V.

Макаренко Станислав Вячеславович — начальник городского организационно-методического отдела по медицинской реабилитации; ассистент кафедры последипломного медицинского образования Медицинского института,

Санкт-Петербург.

Stanislav V. Makarenko, Head, City Organizational and Methodological Department for Medical Rehabilitation; Assistant, Department of Postgraduate Medical Education, Medical Institute, 

Saint-Petersburg.

st.makarenko@gmail.comhttps://orcid.org/0000-0003-1778-0165ПоповО. С.PopovOleg S.

Попов Олег Сергеевич — специалист; младший научный сотрудник медицинского факультета,

Санкт-Петербург.

Oleg S. Popov, Specialist; Junior Researcher of Medical Faculty,

Saint-Petersburg.

ospopov@outlook.comСушенцеваН. Н.SushentsevaNatalya N.

Сушенцева Наталья Николаевна — начальник НИЛ трансляционной биомедицины,

Санкт-Петербург, Сестрорецк.

Natalya N. Sushentseva, Head, Translational Biomedicine Laboratory,

Saint-Petersburg, Sestroretsk.

navicula@yandex.ruhttps://orcid.org/0000-0002-3853-4185АпалькоС. В.ApalkoSvetlana V.

Апалько Светлана Вячеславовна — кандидат биологических наук, начальник научно-исследовательского отдела; старший научный сотрудник медицинского факультета, 

Санкт-Петербург.

Svetlana V.  Apalko, PhD in Biology Sciences, Head, Research Department; Senior Researcher, Medical Faculty, 

Saint-Petersburg.

svetlana.apalko@gmail.comСанкт-Петербургское государственное бюджетное учреждение здравоохранения «Городская больница № 40 Курортного района»РоссияSaint-Petersburg State-financed health-care establishment “City hospital № 40 of Kurortny district” (SPB GBUZ “City hospital № 40”)Russian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Research Medical CenterRussian FederationСанкт-Петербургское государственное бюджетное учреждение здравоохранения «Городская больница № 40 Курортного района»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный университет» Правительства Российской ФедерацииРоссияSaint-Petersburg State-financed health-care establishment “City hospital № 40 of Kurortny district” (SPB GBUZ “City hospital № 40”); Saint-Petersburg State UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Санкт-Петербургский государственный университет» Правительства Российской ФедерацииРоссияSaint-Petersburg State-financed health-care establishmentRussian Federation2025290520253111933Copyright © Петухова О.В., Янишевский С.Н., Щербак С.Г., Сарана А.М., Асиновская А.Ю., Макаренко С.В., Попов О.С., Сушенцева Н.Н., Апалько С.В., 20252025Петухова О.В., Янишевский С.Н., Щербак С.Г., Сарана А.М., Асиновская А.Ю., Макаренко С.В., Попов О.С., Сушенцева Н.Н., Апалько С.В.Petukhova O.V., Yanishevsky S.N., Scherbak S.G., Sarana A.M., Asinovskaya A.Y., Makarenko S.V., Popov O.S., Sushentseva N.N., Apalko S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2533

Актуальность. Ишемический инсульт (ИИ) у пациентов с сахарным диабетом 2-го (СД 2) типа характеризуется более тяжелым течением и худшими по сравнению с лицами без диабета функциональными исходами, что повышает количество инвалидизированных к окончанию госпитализации пациентов. Прогнозирование исхода инсульта при поступлении пациента в стационар может помочь в оптимизации лечебно-диагностических и реабилитационных мероприятий и улучшить качество его лечения. Использование лабораторных биомаркеров (ЛБМ) в прогнозировании исхода ИИ является перспективным направлением современной медицины. Цель исследования — создать прогностическую модель исхода нелакунарного ИИ (НлИИ) у пациентов с СД 2-го типа на основании исследования ЛБМ. Материалы и методы. Исследованы концентрации 78 ЛБМ в сыворотке крови 55 выживших к окончанию госпитализации пациентов с НлИИ и СД 2-го типа. С помощью машинного обучения (МО) выполнен поиск взаимосвязи уровней ЛБМ при поступлении в стационар с исходами острого периода ИИ. Результаты. Выявлены пороговые концентрации интерлейкина (IL)-13 (3,605 пг/мл), IL-6 (1,47 пг/мл), аполипопротеина СII (1516000000,0 нг/мл), растворимого рецептора IL-4 (581,912 пг/мл) и синдекана 4 (26,785 нг/мл), определяющие функциональный исход ИИ, а также пороговые значения субъединицы альфа растворимого рецептора IL-2 (480,802 пг/мл), IL-21 (1,024 пг/мл), белка 15, содержащего домен дезинтегрина и металлопротеиназы (3076,733 пг/мл), растворимого рецептора фактора роста эндотелия сосудов 2 (16300,003 пг/мл), определяющие неврологический исход ИИ у пациентов c СД 2-го типа. Предложены модели прогнозирования функционального и неврологического исхода ИИ у пациентов с СД 2-го типа. Заключение. Исследование ЛБМ может являться полезным вспомогательным инструментом прогнозирования исходов НлИИ у пациентов с СД 2-го типа, что создает потенциальные возможности для реализации персонализированного подхода к ведению таких пациентов и улучшения качества их лечения. 

Background. Ischemic stroke (IS) in patients with type 2 diabetes mellitus (DM 2) is characterized by a more severe course and worse functional outcomes compared to individuals without diabetes, which increases the number of patients disabled by the end of hospitalization. Predicting the outcome of stroke upon admission to hospital can help optimize treatment, diagnostic and rehabilitation measures and improve the quality of treatment. The use of laboratory biomarkers (LBM) in predicting the outcome of IS is a promising area of modern medicine. Objective. To create a prognostic model for the outcome of non-lacunar ischemic stroke (NlIS) in patients with DM 2 based on the LBM study. Design and methods. We studied the serum concentrations of 78 LBM in 55 patients with DM 2 admitted to the hospital due to the development of NlI S. Machine learning (ML) was used to search for a relationship between LBM levels at the time of patient admission to hospital and outcomes of the acute period of stroke. Results. We established the threshold concentrations of interleukin (IL)-13 (3,605 pg/mL), IL-6 (1,47 pg/mL), apolipoprotein CII (1516000000,0 ng/mL), soluble IL-4 receptor (581,912 pg/mL) and syndecan 4 (26,785 ng/mL) that determine the functional outcome of IS, as well as the threshold values of the alpha subunit of the soluble IL-2 receptor (480,802 pg/mL), IL-21 (1,024 pg/mL), protein 15 containing a disintegrin and metalloproteinase domain (3076,733 ng/mL), soluble vascular endothelial growth factor receptor 2 (16,300,003 pg/mL) that determine the neurological outcome of IS in patients with DM 2. Models for predicting the functional and neurological outcome of IS in patients with DM 2 are proposed. Conclusion. LBM research can be a useful auxiliary tool for predicting the outcomes of NlIS in patients with DM 2, which provides opportunities for implementing a personalized approach to the management of these patients and improving the quality of their treatment.

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The authors declare that there are no conflicts of interest present.