TC/(HDL-C+TBIL) and LDL-C/(HDL-C+TBIL) ratios predict early neurological deterioration in minor ischemic stroke：A retrospective study

Abstract

Objective It is generally known that bilirubin and cholesterol can significantly affect the clinical outcome of minor ischemic stroke(MIS) .In other words,early neurological deterioration (END) is still difficult to be predicted which is usually occurs in MIS patients .Our aim was to study the correlation between END,total bilirubin and cholesterol( total cholesterol,TC, low density lipoprotein cholesterol,LDL-C,high density lipoprotein cholesterol,HDL-C) by TC/(HDL-C+TBIL) and LDL-C/(HDL-C+TBIL) ratios. Methods This was a retrospective study.MIS Patients within 48 hours of onset were retrospective recruited from Baoding NO.1 Central Hospital. END was defined as an NIHSS score increased≥ 2 points or individual score of consciousness level and muscle strength increased ≥1 point or new neurological damage manifestations during the 72 hours.During the period,total cholesterol, low density lipoprotein cholesterol,high density lipoprotein cholesterol and total bilirubin , TC/(HDL-C+TBIL) and (LDL-C/(HDL-C+TBIL) ratios were calculated. Results 149 patients were included, 39 cases(26.17%) had END(END group) and 110 cases(73.83%) did not had END(non-END group). In patients with non-END, smoking , TBIL were significantly higher than END(P＜0.05)，but systolic pressure, neutrophil ratio, fasting glucose,LDL-C/(HDL-C+TBIL), TC/(HDL-C+TBIL) were lower(P＜0.05). In tne logistic regression analysis LDL-C/( HDL-C+TBIL) (OR=1.061, 95%CI:1.013~1.111, P=0.012), TC/(HDL-C+TBIL) (OR=1.048, 95%CI:1.008~1.091, P=0.019) were independent risk factors for END. The receiver operated curve (ROC) showed that LDL-C/(HDL-C+TBIL) predicted END with sensitivity 53.8%, specificity 87.3% , TC/(HDL-C+TBIL) predicted END with sensitivity 64.1%, specificity 79.1% . Conclusion END occurs 26.17% in minor ischemic stroke. TC/(HDL-C+TBIL) and (LDL-C/(HDL-C+TBIL) ratios were statistically significant predictor for END in MIS.