Analysis Of Correlation Of Serum Free Fatty Acid And Subtypes Of Acute Ischemic Stroke

ObjectiveSerum non-esterified fatty acids(NEFA), an important energy substrate.some clinical studies in recent decade showed that serum NEFA have an association with cardiovascular diseases, such as coronary atherosclerotic heart disease, acute myocardic infarction,myocardial dysfunction and abnormal cardiac rhythm. However, limited reports suggested that NEFA associated with ischemic stroke. The aim of this study was to examine the association between serum NEFA and subtypes of acute ischemic stroke, especially cardioembolic stroke subtype.Methods1.Study population :We retrospectively selected patients with acute ischemic stroke between October 2013 and October 2014 from The first affiliated hospital of Xia Men university.The clinical features and laboratory parameter of enrolled patents were collected.The stroke classification was divided into five groups according to the TOAST criteria.Then we classified patients into the CE subtype and the non-CE subtype for research needs.2.Statistical analysis:First,the clinical features and laboratory data of patents from CE group and non-CE group were analyzed.Difference between groups were compared with an independent t-test(or Mann-Whitney U test)and chi-square test.To demonstrate the independent association between serum NEFA and the CE subtype,a logistic regression analysis was performed.Results1.Of the 740 patients with acute ischemic stroke,544 patients were analyzed finally.There are 70 patients for CE and 474 for non-CE.The distribution of non-CE patients was 198 for LAA,235 for SVO,184 for ODE and 13 for UDE.2.The onset age of the CE group was higher than the non-CE(P=0.007);the NIHSS scores of the CE group at admission was greatly higher than the non-CE(P<0.001).the concentration of HCRP and NEFA were higher in the CE group compared with non-CE group(P=0.011,P<0.001).3.Logistic regression analysis revealed that an increase NEFA concentration was significantly associated with the cardioembolic subtype(OR 5.981;95%CI:3.826-9.349;P<0.001). A decrease in NIHSS score at admission was associated with the non-CE subtype(P<0.001).4. The analysis showed that Atrial fibrillation(AF) was the main source of cardioembolism. However,the concentration of serum NEFA was also higher in patients with AF than those without AF. In patients with CE stroke subtype,the concentration of serum NEFA were higher no matter with or without AF.Conclusion1.Here we report a significant association between fasting NEFA concentration and the cardioembolic stroke subtype. Serum non-Serum non-esterified fatty acids may be a predictor of the cardioembolic stroke subtype.2.According to the etiological analysis of CE:the cause of this phenomenon is not AF.However,Cardiac arrhythmia and brain damage are suggested as the mediating factors that between NEFA and the cardioembolic.