Higher admission TC/HDL ratio was independently associated with an increased risk of 90-day post-stroke depression, with each 1-SD increase raising the risk by 43.9% (OR 1.4392).
Cohort (n=541)
No
Does the admission TC/HDL ratio predict 90-day post-stroke depression in stroke patients?
Admission TC/HDL ratio is an independent predictor of 90-day post-stroke depression and can be incorporated into a nomogram for early risk stratification.
Odds Ratio: 1.4392 (95% CI 1.1354–1.8361)
valor p: p=0.0028
Background Post-stroke depression (PSD) is a common, impactful complication of stroke, yet clinically applicable early prediction tools remain limited. The ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL) integrates atherogenic burden and neuroprotective reserve, making it a promising candidate for PSD risk stratification. However, its association with 90-day PSD and utility in predictive models remain unestablished. Methods The primary endpoint was PSD at 90 days after stroke. Multivariable logistic regression assessed TC/HDL–PSD association, and restricted cubic spline (RCS) analysis tested non-linearity. A nomogram was constructed and internally validated, with its performance assessed using decision curve, calibration curves, and receiver operating characteristic analysis. Results Thirty-five point seven percent of patients developed PSD. TC/HDL was an independent predictor of PSD (OR = 1.2726, P = 0.0028), with a linear relationship (no nonlinearity; P = 0.879). The highest TC/HDL quartile correlated with a 136.26% increased PSD risk (OR = 2.3626, P = 0.0190). The nomogram, incorporating TC/HDL, NIHSS, MoCA, sex, and neutrophil count, demonstrated good discrimination and calibration. Conclusions Admission TC/HDL is an independent prognostic marker of 90-day PSD, with a linear dose-response relationship. The internally validated nomogram may assist in risk estimation. However, its clinical applicability remains to be established and requires external validation. Given that TC/HDL is a simple, widely available and low-cost biomarker, these findings may support early risk stratification and preventive psychological care in routine stroke management, particularly in resource-limited clinical settings.
Kong et al. (Tue,) conducted a cohort in Acute ischemic stroke (AIS) (n=541). Total cholesterol to high-density lipoprotein cholesterol (TC/HDL) ratio vs. Lower TC/HDL ratio was evaluated on Post-stroke depression (PSD) at 90 days (OR 1.4392, 95% CI 1.1354-1.8361, p=0.0028). Higher admission TC/HDL ratio was independently associated with an increased risk of 90-day post-stroke depression, with each 1-SD increase raising the risk by 43.9% (OR 1.4392).