Correlation Of Serum Lipid Level In Acute Stage Of Stroke And Prognosis: A Prospective Cohort Study

Objective: To investigate the factor associated with serum lipid level in acute stage of stroke. To observe the correlation of serum lipid level in acute stage of stroke and the prognosis. The aim of this study was whether serum lipid level in acute stage of stroke is independent factor associated prognosis or not.Materials and method: The consecutive cases of stroke were prospectively registered in the neurology wards of the West China Hospital, Sichuan Univercity from Mar 1,2003 to Mar 1,2005,of which only the patients within 24 hours from stroke onset were included in the study. Fasting samples of serum lipid estimation were drawn in the next morning of admission, and other data related outcomes were obtained routinely. The outcomes were followed up at the end of 1,3,6 and 12 month after ictus. The outcome measurement was death, dependence and recurrence. The raised serum cholesterol was defmded as the total cholesterol(TC) concentration ≥ 6.0mmol/L, and elevated serum triglyceride(TG) was the level of it≥ 2.0mmol/L .The rasied serum cholesterol and triglyceride were analyzed in relation to age, sex, stroke type, stroke severity, etc by using univariate and multivariate logistic regression respectively to evaluate the factors associated with serum lipid in acute stage stroke. Logistic regression was used toestimate the correlation of serum lipid and prognosis.Results: The total cases of 649 ischemic and hemorrhagic stroke within 24 hours from onset were included. The serum TG range on admission was 0.65 ~ 4.99 mmol/L,and the total of 174 patients had elevated serum triglyceride level. The serum TC range on admission was 1.51 - 8.00 mmol/L(mean,4.62± 1.19mmol/L), and the total of 77 cases had raised serum cholesterol level (≥6.0mmol/L). Independent factors related serum TG and TC level on admission were stroke type and stroke severity. The patients with ischemic stroke had significantly higher serum TC and TG level on admission than those of patients with hemorrhagic stroke. Cholesterol concentration was not a significant predictor of death at the end of first and third month, while triglyceride concentration was. The difference of death and death/disability between two groups is significant. Prognosis of patients with higher TG level was better than that of patients with lower TG level at the end of first and third month.Conclusion: The patients with hemorrhagic stroke had significant lower serum TC and TG level on admission than those of patients with ischemic stroke. Independent factors related serum TG and TC level on admission were stroke type and stroke severity. The patients with ischemic stroke and severe stroke performance could have higher serum TC and TG, and vice versa. Time from stroke onset to adimission and age didn't affect serum TC and TG level on admission. Cholesterol concentration was not a significant predictor of death and death/disability at the end of first and third month, while triglyceride concentration was. The patients with higher serum TG level on admission had better outcome at the end of first and third month.