Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China
Abstract Background This multicenter observational study aimed to determine whether dyslipidemia or obesity contributes more significantly to unfavorable clinical outcomes in patients experiencing a first-ever ischemic stroke (IS). Methods The study employed a machine learning predictive model to in...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-024-02061-9 |
| _version_ | 1827321275342651392 |
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| author | Hang Ruan Xiao Ran Shu-sheng Li Qin Zhang |
| author_facet | Hang Ruan Xiao Ran Shu-sheng Li Qin Zhang |
| author_sort | Hang Ruan |
| collection | DOAJ |
| description | Abstract Background This multicenter observational study aimed to determine whether dyslipidemia or obesity contributes more significantly to unfavorable clinical outcomes in patients experiencing a first-ever ischemic stroke (IS). Methods The study employed a machine learning predictive model to investigate associations among body mass index (BMI), body fat percentage (BFP), high-density lipoprotein (HDL), triglycerides (TG), and total cholesterol (TC) with adverse outcomes in IS patients. Extensive real-world clinical data was utilized, and risk factors significantly linked to adverse outcomes were identified through multivariate analysis, propensity score matching (PSM), and regression discontinuity design (RDD) techniques. Furthermore, these findings were validated via a nationwide multicenter prospective cohort study. Results In the derived cohort, a total of 45,162 patients diagnosed with IS were assessed, with 522 experiencing adverse outcomes. A multifactorial analysis incorporating PSM and RDD methods identified TG (adjusted odds ratio (OR) = 1.110; 95% confidence interval (CI): 1.041–1.183; P < 0.01) and TC (adjusted OR = 1.139; 95%CI: 1.039–1.248; P < 0.01) as risk factors. However, BMI, BFP, and HDL showed no significant effect. In the validation cohort, 1410 controls and 941 patients were enrolled, confirming that lipid levels are more strongly correlated with the prognosis of IS patients compared to obesity (TC, OR = 1.369; 95%CI: 1.069–1.754; P < 0.05; TG, OR = 1.332; 95%CI: 1.097–1.618; P < 0.01). Conclusion This study suggests that dyslipidemia has a more substantial impact on the prognosis of IS patients compared to obesity. This highlights the importance of prioritizing dyslipidemia management in the treatment and prevention of adverse outcomes in IS patients. Graphical abstract |
| first_indexed | 2024-04-25T01:03:30Z |
| format | Article |
| id | doaj.art-1ea707ba8584475786d73ef45abd053d |
| institution | Directory Open Access Journal |
| issn | 1476-511X |
| language | English |
| last_indexed | 2024-04-25T01:03:30Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Lipids in Health and Disease |
| spelling | doaj.art-1ea707ba8584475786d73ef45abd053d2024-03-10T12:21:10ZengBMCLipids in Health and Disease1476-511X2024-03-0123111410.1186/s12944-024-02061-9Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in ChinaHang Ruan0Xiao Ran1Shu-sheng Li2Qin Zhang3Department of Critical-care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical-care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Critical-care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background This multicenter observational study aimed to determine whether dyslipidemia or obesity contributes more significantly to unfavorable clinical outcomes in patients experiencing a first-ever ischemic stroke (IS). Methods The study employed a machine learning predictive model to investigate associations among body mass index (BMI), body fat percentage (BFP), high-density lipoprotein (HDL), triglycerides (TG), and total cholesterol (TC) with adverse outcomes in IS patients. Extensive real-world clinical data was utilized, and risk factors significantly linked to adverse outcomes were identified through multivariate analysis, propensity score matching (PSM), and regression discontinuity design (RDD) techniques. Furthermore, these findings were validated via a nationwide multicenter prospective cohort study. Results In the derived cohort, a total of 45,162 patients diagnosed with IS were assessed, with 522 experiencing adverse outcomes. A multifactorial analysis incorporating PSM and RDD methods identified TG (adjusted odds ratio (OR) = 1.110; 95% confidence interval (CI): 1.041–1.183; P < 0.01) and TC (adjusted OR = 1.139; 95%CI: 1.039–1.248; P < 0.01) as risk factors. However, BMI, BFP, and HDL showed no significant effect. In the validation cohort, 1410 controls and 941 patients were enrolled, confirming that lipid levels are more strongly correlated with the prognosis of IS patients compared to obesity (TC, OR = 1.369; 95%CI: 1.069–1.754; P < 0.05; TG, OR = 1.332; 95%CI: 1.097–1.618; P < 0.01). Conclusion This study suggests that dyslipidemia has a more substantial impact on the prognosis of IS patients compared to obesity. This highlights the importance of prioritizing dyslipidemia management in the treatment and prevention of adverse outcomes in IS patients. Graphical abstracthttps://doi.org/10.1186/s12944-024-02061-9ObesityStrokeTriglycerideTotal cholesterolMachine learning |
| spellingShingle | Hang Ruan Xiao Ran Shu-sheng Li Qin Zhang Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China Lipids in Health and Disease Obesity Stroke Triglyceride Total cholesterol Machine learning |
| title | Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China |
| title_full | Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China |
| title_fullStr | Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China |
| title_full_unstemmed | Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China |
| title_short | Dyslipidemia versus obesity as predictors of ischemic stroke prognosis: a multi-center study in China |
| title_sort | dyslipidemia versus obesity as predictors of ischemic stroke prognosis a multi center study in china |
| topic | Obesity Stroke Triglyceride Total cholesterol Machine learning |
| url | https://doi.org/10.1186/s12944-024-02061-9 |
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