Lipid Profile Abnormalities in Nondiabetic Stroke Patients: A Hospital-based Case–Control Study from North India

risk.However, a substantial proportion of stroke patients in India are nondiabetic, in whom lipid abnormalities may operate as a primary driver of vascular pathology.Existing studies have largely evaluated mixed populations, leaving a gap in understanding lipid abnormalities specifically in nondiabetic stroke patients.Populationbased evidence from the EUROSTROKE study and observational data from South Asian cohorts have demonstrated that elevated total and LDL-C independently predict ischemic cerebrovascular events, including in individuals without diabetes.6,7 The present study was therefore undertaken to evaluate and compare the full lipid profile between nondiabetic stroke patients and age-and sex-matched healthy controls at a tertiary care center in North India. IntroductIonStroke is recognized as the second leading cause of death globally and a major contributor to disability-adjusted life years (DALYs), with ischemic stroke accounting for the majority of cases worldwide.1 The absolute number of stroke events has increased substantially due to population aging and rising prevalence of vascular risk factors.In India, stroke incidence ranges from 119 to 145 per 100,000 population annually, with a significant proportion occurring at a younger age than in Western populations, predominantly affecting the working-age group with severe socioeconomic consequences.2 Dyslipidemia is a well-established modifiable risk factor for atherosclerosis and cerebrovascular disease.Elevated low-density lipoprotein cholesterol (LDL-C) promotes endothelial dysfunction, lipid deposition, and plaque formation within arterial walls, while reduced high-density lipoprotein cholesterol (HDL-C) impairs reverse cholesterol transport and anti-inflammatory vascular protection.3 The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial established that high-dose atorvastatin significantly reduces recurrent stroke risk irrespective of diabetic status. 4 The Cholesterol Treatment Trialists' (CTT) Collaboration further demonstrated that each 1 mmol/L reduction in LDL-C is associated with a significant decrease in ischemic stroke risk.5 Diabetes mellitus profoundly alters lipid metabolism and may confound the relationship between lipid profile and stroke 1-