Association of non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio with stroke severity and short-term outcome in patients with acute ischemic stroke
10.3760/cma.j.issn.1673-4165.2025.05.004
- VernacularTitle:非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值与急性缺血性卒中患者卒中严重程度及短期转归的相关性
- Author:
Shiyin MA
1
;
Deguo MENG
;
Kaige XUAN
;
Chang HE
;
Xiaoyan ZHU
;
Xudong PAN
Author Information
1. 青岛大学附属医院神经内科，青岛 266000
- Keywords:
Brain ischemia;
Cholesterol;
Cholesterol, HDL;
Severity of illness index;
Treatment outcome;
Risk factors;
Biomarkers
- From:
International Journal of Cerebrovascular Diseases
2025;33(5):343-349
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate association of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with the stroke severity and short-term outcome in patients with acute ischemic stroke (AIS), and to evaluate the predictive value of NHHR for outcome.Methods:Patients with the first-ever AIS admitted to the Affiliated Hospital of Qingdao University from June 2018 to June 2024 whose etiological types were large artery atherosclerosis (LAA), small vessel occlusion (SVO) and cardiac embolism (CE) were included retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS) score at admission, the patients were divided into mild stroke group (≤8) and moderate to severe stroke group (>8). According to the modified Rankin Scale score at discharge, they were divided into good outcome group (≤2) and poor outcome group (>2). Multivariate logistic regression analysis was use to determine the independent correlation between NHHR and stroke severity and short-term outcome in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NHHR for short-term poor outcome in overall patients with AIS and different etiological subtypes. Results:A total of 2 865 patients with AIS were enrolled, including 1 925 males (67.2%), aged (61.00 ± 10.17) years. 2 483 patients (86.67%) had mild stroke and 382 (13.33%) had moderate to severe stroke; 2 161 (75.43%) had good short-term outcome, while 704 (24.57%) had poor short-term outcome. Multivariate logistic regression analysis showed that NHHR was significantly and independently associated with moderate to severe stroke (odds ratio [ OR] 2.251, 95% confidence interval [ CI] 1.895-2.675; P<0.001) and poor short-term outcome ( OR 3.454, 95% CI 2.936-4.063; P<0.001). ROC curve analysis showed that NHHR had a high predictive value for short-term poor outcome in patients with AIS (the area under the curve [AUC] 0.764, 95% CI 0.745-0.784), and it also demonstrated high predictive value in patients with various etiological types such as LAA (AUC=0.755, 95% CI 0.730-0.781), SVO (AUC=0.801, 95% CI 0.777-0.824) and CE (AUC=0.797, 95% CI 0.774-0.820). Conclusion:NHHR is significantly correlated with the severity of stroke and poor short-term outcome in patients with AIS, and has a high predictive value for poor short-term outcome.
