Why the study?
Bile acids affect lipid metabolism, atherosclerosis, apoptosis, and neuroprotection, but few studies had evaluated serum total bile acid levels regarding acute ischemic stroke severity and prognosis.
Do higher admission fasting serum total bile acid levels reduce 3-month mortality in patients with acute ischemic stroke?
Do higher admission fasting serum total bile acid levels reduce 3-month mortality in patients with acute ischemic stroke?
Higher admission serum total bile acid levels are independently associated with a decreased risk of 3-month all-cause mortality in patients with acute ischemic stroke.
Should not yet change AIS risk assessment; leaves open TBA as a hypothesis-generating mortality biomarker needing prospective validation.
Background: Bile acids not only play an important role in lipid metabolism and atherosclerosis, but also have anti-apoptosis and neuroprotective effects. However, few studies have focused on the relationship of TBA levels with the severity and prognosis of AIS. Objectives: The aim of this study is to investigate the potential associations of admission fasting serum TBA levels with stroke severity, in-hospital complication incidence and 3 -month all-cause mortality in patients of AIS. Methods: A total of 777 AIS patients were finally enrolled in this study and divided into four groups according to the quartiles of serum TBA levels on admission. Results: 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 progressed (NIHSS score increased by ≥ 2), and 222 patients (28.6%) developed at least one complication, with no statistical 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 and 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 3-month follow-up, respectively 42 (21.3%), 26 (13.3%), 19 (9.9%) and 27 (13.9%) in groups Q1, Q2, Q3 and Q4 with statistical difference ( P = 0.013). After adjustments for confounding factors, the risk of death decreased ( P -trend < 0.05) in groups Q2, Q3, and Q4 progressively compared with group Q1, with OR values of 0.36 (0.16-0.80), 0.30 (0.13-0.70), and 0.29 (0.13-0.65), respectively. Conclusions: TBA level presents no significant association with the severity of stroke and incidence of complications in patients of AIS, but negatively correlates to the risk of death within 3 months of onset.
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Huang et al. (2021) studied this question.
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