Abstract：
BACKGROUND: Bile acids (BAs) not only play an important role in lipid metabolism and atherosclerosis but also have antiapoptotic and neuroprotective effects. However, few studies have focused on the relationship of the total bile acid (TBA) levels with the severity and prognosis of acute ischemic stroke (AIS).
OBJECTIVE: The aim of this study was to investigate the potential associations of the fasting serum TBA levels on admission with the stroke severity, in-hospital complication incidence and 3 -month all-cause mortality in patients with AIS.
METHODS: A total of 777 consecutive AIS patients were enrolled in this study and were divided into four groups according to the quartiles of the serum TBA levels on admission. Univariate and multivariate logistic regression analyses were used to explore the relationship between the fasting TBA levels and the stroke severity, in-hospital complications, and 3-month mortality in AIS patients.
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 progression (NIHSS score increased by ≥ 2), and 222 patients (28.6%) developed at least one complication, with no significant 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 or 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 the 3-month follow-up, including 42 (21.3%), 26 (13.3%), 19 (9.9%) and 27 (13.9%) patients in groups Q1, Q2, Q3 and Q4 respectively, with significant differences (P = 0.013). After adjusting for confounding factors, the risk of death decreased (P -trend < 0.05) in groups Q2, Q3, and Q4 when compared with group Q1, and the OR values were 0.36 (0.16-0.80), 0.30 (0.13-0.70), and 0.29 (0.13-0.65), respectively.
CONCLUSIONS: TBA levels were inversely associated with the 3-month mortality of AIS patients but were not significantly associated with the severity of stroke or the incidence of complications.
OBJECTIVE: The aim of this study was to investigate the potential associations of the fasting serum TBA levels on admission with the stroke severity, in-hospital complication incidence and 3 -month all-cause mortality in patients with AIS.
METHODS: A total of 777 consecutive AIS patients were enrolled in this study and were divided into four groups according to the quartiles of the serum TBA levels on admission. Univariate and multivariate logistic regression analyses were used to explore the relationship between the fasting TBA levels and the stroke severity, in-hospital complications, and 3-month mortality in AIS patients.
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 progression (NIHSS score increased by ≥ 2), and 222 patients (28.6%) developed at least one complication, with no significant 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 or 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 the 3-month follow-up, including 42 (21.3%), 26 (13.3%), 19 (9.9%) and 27 (13.9%) patients in groups Q1, Q2, Q3 and Q4 respectively, with significant differences (P = 0.013). After adjusting for confounding factors, the risk of death decreased (P -trend < 0.05) in groups Q2, Q3, and Q4 when compared with group Q1, and the OR values were 0.36 (0.16-0.80), 0.30 (0.13-0.70), and 0.29 (0.13-0.65), respectively.
CONCLUSIONS: TBA levels were inversely associated with the 3-month mortality of AIS patients but were not significantly associated with the severity of stroke or the incidence of complications.
摘要：
背景：胆汁酸（BA）不仅在脂质代谢和动脉粥样硬化中起重要作用，而且还具有抗凋亡和神经保护作用。然而,很少有研究关注总胆汁酸（TBA）水平与急性缺血性卒中（AIS）严重程度和预后的关系。
目的：本研究的目的是探讨入院时空腹血清TBA水平与卒中严重程度的潜在关联，AIS患者的院内并发症发生率和3个月全因死亡率。
方法：本研究共纳入777例AIS患者，根据入院时血清TBA水平的四分位数分为四组。单因素和多因素logistic回归分析用于探讨空腹TBA水平与卒中严重程度之间的关系。住院并发症,AIS患者的3个月死亡率。
结果：Q3组患者发生严重AIS的风险最低（NIHSS>10），而不考虑混杂因素的调整（P<0.05）。住院期间,115例患者（14.8%）出现卒中进展（NIHSS评分增加≥2），222例患者（28.6%）出现至少一种并发症，四组间差异无统计学意义(P>0.05)。肺炎的发病率无显著差异,尿路感染（UTI），出血性转化（HT），消化道出血（GIB），四组癫痫发作或肾功能不全（RI）（P>0.05）。在3个月的随访中，共有114名患者（14.7%）死于各种原因（包括院内死亡），包括42人(21.3%)，26（13.3%），Q1，Q2，Q3和Q4组分别有19例（9.9％）和27例（13.9％）患者，差异有统计学意义(P=0.013)。在调整混杂因素后，与Q1组比较，Q2、Q3、Q4组的死亡风险降低（P趋势<0.05），OR值为0.36（0.16～0.80），0.30（0.13-0.70），和0.29（0.13-0.65），分别。
结论：TBA水平与AIS患者3个月死亡率呈负相关，但与卒中严重程度或并发症发生率无显著相关。
目的：本研究的目的是探讨入院时空腹血清TBA水平与卒中严重程度的潜在关联，AIS患者的院内并发症发生率和3个月全因死亡率。
方法：本研究共纳入777例AIS患者，根据入院时血清TBA水平的四分位数分为四组。单因素和多因素logistic回归分析用于探讨空腹TBA水平与卒中严重程度之间的关系。住院并发症,AIS患者的3个月死亡率。
结果：Q3组患者发生严重AIS的风险最低（NIHSS>10），而不考虑混杂因素的调整（P<0.05）。住院期间,115例患者（14.8%）出现卒中进展（NIHSS评分增加≥2），222例患者（28.6%）出现至少一种并发症，四组间差异无统计学意义(P>0.05)。肺炎的发病率无显著差异,尿路感染（UTI），出血性转化（HT），消化道出血（GIB），四组癫痫发作或肾功能不全（RI）（P>0.05）。在3个月的随访中，共有114名患者（14.7%）死于各种原因（包括院内死亡），包括42人(21.3%)，26（13.3%），Q1，Q2，Q3和Q4组分别有19例（9.9％）和27例（13.9％）患者，差异有统计学意义(P=0.013)。在调整混杂因素后，与Q1组比较，Q2、Q3、Q4组的死亡风险降低（P趋势<0.05），OR值为0.36（0.16～0.80），0.30（0.13-0.70），和0.29（0.13-0.65），分别。
结论：TBA水平与AIS患者3个月死亡率呈负相关，但与卒中严重程度或并发症发生率无显著相关。
