{"title":"Association between lipid profiles and early clinical outcomes in acute ischemic stroke: a single-center cohort study in the Chinese population.","authors":"Duanlu Hou, Yuanyuan Wang, Shuang Zhai, Xiaoli Yang, Yuping Tang, Danhong Wu","doi":"10.1186/s12883-025-04444-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The clinical significance and contribution of the lipid profile in atherosclerosis are well established. However, further investigation is needed in stroke patients, particularly regarding apolipoprotein B100 (ApoB100), a novel non-traditional lipid component in the lipid profile.</p><p><strong>Objectives: </strong>To explore lipid parameters and their impact on stroke outcomes in patients with and without thrombolysis.</p><p><strong>Methods: </strong>We prospectively enrolled patients with acute ischemic stroke (AIS) at a single center, including those who did and did not receive thrombolysis. Participants were stratified into improvement (favorable outcome at 2 weeks) and non-improvement groups. Demographic, laboratory, imaging, and clinical scale data were compared between groups. Random forest analyses were used to evaluate the predictive value and importance of individual lipid measures: triglycerides, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), ApoB100, and lipoprotein(a), which better describe the internal characteristics of the profile.</p><p><strong>Results: </strong>Complete data were available for 262 AIS patients, 165 of whom received thrombolysis. Plasma ApoB100 levels were significantly lower in the thrombolysis group (p < 0.001) and decreased ApoB100 levels were independently associated with 2-week stroke improvement (p = 0.009, OR = 0.89, 95% CI: 0.84-0.93). Random-forest feature-importance plots revealed that HDL and ApoB100 (each contributing > 15%) were the strongest lipid predictors of a favorable outcome, outperforming the other lipid variables.</p><p><strong>Conclusions: </strong>We found that thrombolysis is associated with ApoB100 decrease and a decrease in ApoB100 can predict the 2-week functional improvement in stroke. HDL and ApoB100 emerge as more important determinants of favorable AIS outcomes in this machine-learning analysis. These findings warrant external validation in multi-center trials.</p><p><strong>Trial registration: </strong>ChiCTR1800018315, 11/09/2018.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"429"},"PeriodicalIF":2.2000,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532402/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-025-04444-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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Abstract
Background: The clinical significance and contribution of the lipid profile in atherosclerosis are well established. However, further investigation is needed in stroke patients, particularly regarding apolipoprotein B100 (ApoB100), a novel non-traditional lipid component in the lipid profile.
Objectives: To explore lipid parameters and their impact on stroke outcomes in patients with and without thrombolysis.
Methods: We prospectively enrolled patients with acute ischemic stroke (AIS) at a single center, including those who did and did not receive thrombolysis. Participants were stratified into improvement (favorable outcome at 2 weeks) and non-improvement groups. Demographic, laboratory, imaging, and clinical scale data were compared between groups. Random forest analyses were used to evaluate the predictive value and importance of individual lipid measures: triglycerides, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), ApoB100, and lipoprotein(a), which better describe the internal characteristics of the profile.
Results: Complete data were available for 262 AIS patients, 165 of whom received thrombolysis. Plasma ApoB100 levels were significantly lower in the thrombolysis group (p < 0.001) and decreased ApoB100 levels were independently associated with 2-week stroke improvement (p = 0.009, OR = 0.89, 95% CI: 0.84-0.93). Random-forest feature-importance plots revealed that HDL and ApoB100 (each contributing > 15%) were the strongest lipid predictors of a favorable outcome, outperforming the other lipid variables.
Conclusions: We found that thrombolysis is associated with ApoB100 decrease and a decrease in ApoB100 can predict the 2-week functional improvement in stroke. HDL and ApoB100 emerge as more important determinants of favorable AIS outcomes in this machine-learning analysis. These findings warrant external validation in multi-center trials.
期刊介绍：
BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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