Relationship between the Ratio of Low-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol and the Condition and Prognosis of Patients with Acute Ischemic Stroke

ZHENG Chenzhuo; LEI Yasong; GONG Hao

doi:10.16458/j.cnki.1007-0893.2025.15.008

Abstract：Objective To explore the influence of the ratio of low-density lipoprotein cholesterol(LDL-C)to high-density lipoprotein cholesterol(HDL-C)on the severity and prognosis of patients with acute ischemic stroke(AIS).Methods A total of 90 AIS patients admitted to Nanyang Central Hospital from September 2021 to September 2024 were selected as the observation subjects.The 90 patients were divided into a mild-to-moderate injury group(36 cases)and a severe injury group(54 cases)based on the degree of neurological deficits.After discharge,the patients were followed up for 3 months.According to the modified Rankin scale(mRS),the 90 subjects were divided into a good prognosis group(63 cases)and a poor prognosis group(27 cases).The levels of serum LDL-C,HDL-C,and the LDL-C/HDL-C ratio were compared among the subgroups.Pearson correlation analysis was used for correlation analysis,and multivariate analysis was conducted using the Logistic regression model.The predictive value of serum LDL-C/HDL-C ratio for the prognosis of AIS was evaluated by the receiver operating characteristic(ROC)curve.Results The level of serum LDL-C and LDL-C/HDL-C ratio in the severe injury group were significantly higher than those in the mild to moderate injury group,while the level of HDL-C was significantly lower than that in the mild to moderate injury group,and the difference was statistically significant(P<0.001).The level of serum LDL-C and LDL-C/HDL-C ratio in the poor prognosis group were significantly higher than those in the good prognosis group,while the level of HDL-C was significantly lower than that in the good prognosis group(P<0.001).Correlation analysis showed that the level of serum LDL-C and LDL-C/HDL-C ratio were positively correlated with the severity of AIS(r=0.442,0.467,both P<0.05),while the level of HDL-C was negatively correlated with the severity of AIS(r=-0.453,P<0.001).The differences in age,the proportion of males,the proportions of history of stroke,diabetes,hyperlipidemia and smoking,the levels of serum LDL-C and HDL-C,and the LDL-C HDL-C ratio between the patients in the poor prognosis group and the good prognosis group were statistically significant(P<0.05).There was no statistically significant difference in the proportions of patients with a history of hypertension,coronary heart disease and alcohol consumption between the two groups(P>0.05).Multivariate Logistic regression analysis showed that age,male gender,history of stroke,history of diabetes,hyperlipidemia,smoking history,LDL-C,and LDL-C/HDL-C were risk factors for poor prognosis in AIS patients(P<0.05),while HDL-C was a protective factor for poor prognosis in AIS patients(P<0.001).The ROC curve results showed that the area under the curve(AUC)of LDL-C,HDL-C,and LDL-C/HDL-C were 0.724,0.768,and 0.839,respectively,with sensitivities of 0.692,0.889,and 0.778,and specificities of 0.861,0.711,and 0.806,respectively.Conclusion The LDL-C HDL-C ratio is closely related to the severity and prognosis of AIS patients,suggesting that monitoring and regulating lipid levels may help improve the condition and prognosis of AIS patients.