Department of Neurology, Zhangjiagang TCM Hospital, Nanjing University of Chinese Medicine in China, 215600, Suzhou, China.
Lipids Health Dis. 2022 Jan 22;21(1):15. doi: 10.1186/s12944-021-01620-8.
Bile acids (BAs) not only play an important role in lipid metabolism and atherosclerosis but also have antiapoptotic and neuroprotective effects. However, few studies have focused on the relationship of the total bile acid (TBA) levels with the severity and prognosis of acute ischemic stroke (AIS).
The aim of this study was to investigate the potential associations of the fasting serum TBA levels on admission with the stroke severity, in-hospital complication incidence and 3 -month all-cause mortality in patients with AIS.
A total of 777 consecutive AIS patients were enrolled in this study and were divided into four groups according to the quartiles of the serum TBA levels on admission. Univariate and multivariate logistic regression analyses were used to explore the relationship between the fasting TBA levels and the stroke severity, in-hospital complications, and 3-month mortality in AIS patients.
Patients in group Q3 had the lowest risk of severe AIS (NIHSS > 10) regardless of the adjustments for confounders (P < 0.05). During hospitalization, 115 patients (14.8%) had stroke progression (NIHSS score increased by ≥ 2), and 222 patients (28.6%) developed at least one complication, with no significant difference among the four groups (P > 0.05). There was no significant difference in the incidence of pneumonia, urinary tract infection (UTI), hemorrhagic transformation (HT), gastrointestinal bleeding (GIB), seizures or renal insufficiency (RI) among the four groups (P > 0.05). A total of 114 patients (14.7%) died from various causes (including in-hospital deaths) at the 3-month follow-up, including 42 (21.3%), 26 (13.3%), 19 (9.9%) and 27 (13.9%) patients in groups Q1, Q2, Q3 and Q4 respectively, with significant differences (P = 0.013). After adjusting for confounding factors, the risk of death decreased (P -trend < 0.05) in groups Q2, Q3, and Q4 when compared with group Q1, and the OR values were 0.36 (0.16-0.80), 0.30 (0.13-0.70), and 0.29 (0.13-0.65), respectively.
TBA levels were inversely associated with the 3-month mortality of AIS patients but were not significantly associated with the severity of stroke or the incidence of complications.
胆汁酸（BAs）不仅在脂质代谢和动脉粥样硬化中发挥重要作用，而且具有抗凋亡和神经保护作用。然而，很少有研究关注空腹血清总胆汁酸（TBA）水平与急性缺血性脑卒中（AIS）严重程度和预后的关系。
本研究旨在探讨入院时空腹血清 TBA 水平与 AIS 患者的卒中严重程度、住院期间并发症发生率和 3 个月全因死亡率之间的潜在关系。
共纳入 777 例连续 AIS 患者，根据入院时血清 TBA 水平的四分位间距将其分为 4 组。采用单因素和多因素 logistic 回归分析探讨空腹 TBA 水平与 AIS 患者卒中严重程度、住院期间并发症和 3 个月死亡率之间的关系。
无论是否调整混杂因素，Q3 组患者发生重度 AIS（NIHSS > 10）的风险最低（P < 0.05）。住院期间，115 例（14.8%）患者发生卒中进展（NIHSS 评分增加≥2），222 例（28.6%）患者发生至少一种并发症，4 组间无显著差异（P > 0.05）。4 组间肺炎、尿路感染（UTI）、出血性转化（HT）、胃肠道出血（GIB）、癫痫发作或肾功能不全（RI）的发生率无显著差异（P > 0.05）。在 3 个月的随访中，共有 114 例（14.7%）患者因各种原因死亡（包括院内死亡），分别为 Q1 组 42 例（21.3%）、Q2 组 26 例（13.3%）、Q3 组 19 例（9.9%）和 Q4 组 27 例（13.9%），差异有统计学意义（P = 0.013）。调整混杂因素后，与 Q1 组相比，Q2、Q3 和 Q4 组的死亡风险降低（P -趋势<0.05），OR 值分别为 0.36（0.16-0.80）、0.30（0.13-0.70）和 0.29（0.13-0.65）。
TBA 水平与 AIS 患者 3 个月死亡率呈负相关，但与卒中严重程度或并发症发生率无显著相关性。
