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Journal of the Korean Neurological Association 2008;26(2): 95-103.
혈청 중성 지방과 급성 허혈성 뇌경색의 조기 예후와의 관계
최강호, 박만석 강경욱 김준태 최성민 이승한 김병채 김명규 조기현
전남대학교 의과대학 신경과학교실
Association Between Serum Triglyceride Level and Early Prognosis of Acute Ischemic Stroke
Kang-Ho Choi
Departement of Neurology, Chonnam National University Hospital, Gwangju, Korea
Background: Although the association between serum cholesterol levels and cerebrovascular disorder has been extensively studied, the relationship between cholesterol levels and outcome following ischemic stroke remains to be established. We evaluated the association between serum triglyceride levels and the early prognosis of acute ischemic stroke.
Methods: Among 1096 patients who were admitted to the Neurology department of Chonnam National University Hospital from June 2005 to April 2007, 598 consecutive patients with acute ischemic stroke were enrolled in this study. Patients were divided into five groups based on serum triglyceride levels.
Results: The level of triglyceride was significantly lower in patients with 4 or more improvement in NIHSS score than in patients without improvement (100.4 versus 135.0 mg/dl, p<0.001). In a univariate analysis, thrombolytic therapy (p<0.001), atrial fibrillation (p<0.001), lower total cholesterol (p=0.001), lower LDL cholesterol (p=0.019) and previous statin therapy (p=0.042) were also associated with a better functional outcome. After adjustment for known confounding variables, multivariate and survival analysis showed that a lower triglyceride level above the normal range remained an independent predictor of better functional outcome (p=0.002). Previous statin therapy and thrombolytic therapy were also independent predictors for better functional outcome (p=0.044;p<0.001). However, extremely low triglyceride level (<50.0 mg/dl) was associated with poor functional outcome after an acute ischemic stroke.
Conclusions: These results suggest that serum triglyceride measurements in acute ischemic stroke could be helpful in predicting clinical improvement. Further prospective studies are required to determine whether triglyceride is an independent predictor for better functional outcome.