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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
Volume 16 - 2025 |
doi: 10.3389/fneur.2025.1472871
This article is part of the Research Topic Advances and controversies in ischemic stroke management: from prevention to diagnosis and acute treatment View all 94 articles
Impact of Remnant Cholesterol on Acute Ischemic Stroke Prognosis: A Nationwide Cohort Analysis Stratified by Non-Alcoholic Fatty Liver Disease Status
Provisionally accepted- 1 Department of Cerebrovascular Disease, Suining Central Hospital, Suining, China
- 2 Beijing Tiantan Hospital, Capital Medical University, Beijing, Beijing Municipality, China
Background: Remnant cholesterol (RC), an emerging non-traditional risk factor for cardiovascular diseases, has attracted increasing attention. Additionally, non-alcoholic fatty liver disease (NAFLD) may interact synergistically with RC. This study aims to evaluate the association between RC and functional outcomes in ischemic stroke patients and to investigate the potential interaction effect between RC and NAFLD.Methods: This study utilized data from the CNSR-III (Third China National Stroke Registry), including ischemic stroke patients followed for 3 months post-stroke onset.RC was calculated as total cholesterol minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3 to 6 at the 3-month follow-up.Multivariable logistic regression analyses were conducted to determine the association between RC and functional outcome. Interaction effect analysis were applied to investigate how NAFLD modifies the relationship between RC and prognosis.Results: Among the 7, 234 participants, the mean age was 62.96 ± 11.44 years, and 4,572 (63.2%) were males. Compared with the lowest quartile of RC (Q1), the highest quartile of RC (Q4) was associated with a lower risk of poor functional outcomes (OR:0.98, 95% CI:0.96-1.00). Meanwhile, we observed a similar relationship between RC and poor functional outcomes in patients with NAFLD (OR:0.96, 95% CI:0.93-0.99); however, in those with non-NAFLD, there was no significant association between RC and poor functional outcomes.We found an inverse relationship between RC levels and poor functional outcomes in patients with ischemic stroke, which was influenced by NAFLD. Future studies about optimal target RC levels in NAFLD patients are needed.
Keywords: Residual cholesterol, ischemic stroke, Non-alcoholic fatty liver disease, Stroke prognosis, CNSR-III
Received: 30 Jul 2024; Accepted: 16 Jan 2025.
Copyright: © 2025 Jiang, Jin, Xing and JING. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenli Xing, Department of Cerebrovascular Disease, Suining Central Hospital, Suining, China
JING JING, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, Beijing Municipality, China
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