Association between Lipid Accumulation Product and 3-Month Functional Outcome after Ischemic Stroke: the...

To explore the association of lipid accumulation product (LAP) with 3-month functional outcome and etiologic subtypes in patients with acute ischemic stroke. Patients with acute ischemic stroke admitted from July 1, 2020, to June 30, 2022 were enrolled in this study. Initial neurological severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was evaluated by the modified Rankin Scale (mRS) at 3 months after ischemic stroke onset. Etiologic subtypes were determined according to the method reported in the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. LAP was calculated by a well-established formula and analyzed by quartiles (Q1-Q4). Multivariate logistic regression analysis was conducted to evaluate the association of LAP quartiles with 3-month functional outcome and etiologic subtypes in patients with acute ischemic stroke. A total of 431 patients with acute ischemic stroke were included in this study. After adjusting for several confounding factors, compared with those in the LAP-Q1 group, patients in LAP-Q3 and LAP-Q4 group had a reduced association with poor 3-month functional outcome [odds ratio (OR): 0.038, 95% confidence interval (CI): 0.004-0.339; OR: 0.014, 95% CI: 0.001-0.158]. Furthermore, patients in LAP-Q3 and LAP-Q4 group showed an increased association with Small-artery occlusion (SAO) subtype (OR: 1.919, 95% CI: 1.075-3.425; OR: 2.322, 95% CI: 1.265-4.262). Elevated LAP levels were associated with favorable 3-month functional outcome in patients with acute ischemic stroke, supporting the concept of the "obesity-stroke paradox". Concurrently, patients with elevated LAP levels were more likely to experience SAO as the etiological subtype of their stroke.