# Association between circulating plasma CTRP3 levels and acute ischemic stroke: a systematic review and meta-analysis

## TL;DR

This study finds that people with acute ischemic stroke have lower levels of a protein called CTRP3 in their blood compared to healthy individuals.

## Contribution

The study resolves conflicting evidence by showing a consistent decrease in CTRP3 levels in stroke patients and identifies age and BMI as key factors influencing this association.

## Key findings

- Patients with acute ischemic stroke had significantly lower circulating CTRP3 levels than controls.
- Heterogeneity in results was mainly due to differences in patient age and body mass index (BMI).

## Abstract

C1q tumor necrosis factor (TNF)-related protein 3 (CTRP3) is a novel adipokine that has been shown to exert neuroprotective effects in acute cerebral infarction. However, conflicting results have emerged regarding the circulating levels of CTRP3 between patients with acute ischemic stroke and healthy individuals. This meta-analysis aims to investigate the association between circulating CTRP3 levels and acute ischemic stroke.

The objective of this meta-analysis is to re-evaluate the relationship between circulating CTRP3 levels and acute ischemic stroke.

We conducted a comprehensive search across PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang Data, and CBM to identify relevant studies up to February 2025 and 110 articles were found. After screening the titles, abstracts, and full texts, a total of 14 articles were ultimately included in this meta-analysis. Due to high heterogeneity, we conducted subgroup analyses stratified by patient characteristics, clinical and biochemical parameters, carotid intima-media thickness, IL-6 levels, CTRP9 levels, smoking, hypertension, and diabetes. Publication bias was evaluated using Egger’s regression test, Begg’s correlation analysis, and funnel plot visualizations.

The results indicated that patients with acute ischemic stroke exhibited significantly lower circulating levels of CTRP3 compared with control group (Z = 6.04, P < 0.00001). Subgroup analysis revealed that the observed heterogeneity could be attributed to patient age and body mass index (BMI). The year of publication, clinical biochemical parameters, carotid intima-media thickness, IL-6, CTRP9, smoking, hypertension, and diabetes categorization were not sources of heterogeneity.

The meta-analysis confirmed that circulating levels of CTRP3 were significantly lower in patients with acute ischemic stroke compared with control group. This association may be modulated by patient age and BMI.