Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis

ObjectiveModerate-to-severe stenosis has been identified as a significant risk factor for stroke recently. This study aims to investigate the relationship between non-traditional lipid parameters and the location and distribution of stenosis, as well as symptomatic events, in patients with moderate-...

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Main Authors: Yin Fei Huang, Zhen Xing Liu, Kuan Cen, Ren Wei Zhang, Qiao Yuan Xiang, Qi Cai, Chun Jiao Yang, Lei Luo, Hai Long Xu, Yu Xie, Yu Min Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1564966/full
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author Yin Fei Huang
Zhen Xing Liu
Kuan Cen
Ren Wei Zhang
Qiao Yuan Xiang
Qi Cai
Chun Jiao Yang
Lei Luo
Hai Long Xu
Yu Xie
Yu Min Liu
author_facet Yin Fei Huang
Zhen Xing Liu
Kuan Cen
Ren Wei Zhang
Qiao Yuan Xiang
Qi Cai
Chun Jiao Yang
Lei Luo
Hai Long Xu
Yu Xie
Yu Min Liu
author_sort Yin Fei Huang
collection DOAJ
description ObjectiveModerate-to-severe stenosis has been identified as a significant risk factor for stroke recently. This study aims to investigate the relationship between non-traditional lipid parameters and the location and distribution of stenosis, as well as symptomatic events, in patients with moderate-to-severe intracranial atherosclerotic stenosis (ICAS) and extracranial atherosclerotic stenosis (ECAS).MethodsThis study analyzed correlation between non-traditional lipid parameters and moderate-to-severe ICAS and ECAS concerning stenosis location, distribution, and the presence or absence of symptoms. Logistic models and restricted spline analysis were utilized to explore the relationship between Castelli's risk index-II (CRI-II) and the occurrence of stroke events.ResultsThe present study comprised 1,030 participants, of whom 143 were non-stenotic and 887 were patients with moderate-to-severe stenosis. The study focuses on the latter and indicated statistically significant differences in AIP, LCI, RC, AC, CRI-I, and CRI-II among the three groups of ICAS, ECAS, and combined ICAS and ECAS (P = 0.012, 0.005, 0.013, 0.009, 0.009, 0.032, respectively). Lipid parameters for ICAS were generally higher than those for ECAS. Remnant cholesterol (RC) exhibited a discrepancy among the anterior, posterior, and combined anterior and posterior circulation stenosis groups (P = 0.047). Logistic regression analysis revealed that CRI-II (Odds ratio [OR] = 1.20, Confidence interval [CI] 1.03–1.40, P = 0.009) and low-density lipoprotein cholesterol (LDL-c) (OR = 1.21, CI 1.03–1.42, P = 0.011) demonstrated remarkable elevations in symptomatic stenosis patients compared to patients without symptoms. After adjusting for potential confounding factors, CRI-II remained an independent risk factor for symptomatic stenosis. Furthermore, multivariate spline regression modeling elucidated that an augmented risk of stroke events in moderate-to-severe stenosis was associated with an elevated CRI-II. As CRI-II elevated, the risk of stroke events increased progressively.
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spelling doaj-art-30d3f20886e54c488eb7f753386cdbd32025-08-20T03:28:22ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.15649661564966Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosisYin Fei Huang0Zhen Xing Liu1Kuan Cen2Ren Wei Zhang3Qiao Yuan Xiang4Qi Cai5Chun Jiao Yang6Lei Luo7Hai Long Xu8Yu Xie9Yu Min Liu10Department of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Yiling Hospital of Yichang City, Yichang, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Yiling Hospital of Yichang City, Yichang, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaDepartment of Neurology, Zhongnan Hospital Affiliated to Wuhan University, Wuhan, Hubei, ChinaObjectiveModerate-to-severe stenosis has been identified as a significant risk factor for stroke recently. This study aims to investigate the relationship between non-traditional lipid parameters and the location and distribution of stenosis, as well as symptomatic events, in patients with moderate-to-severe intracranial atherosclerotic stenosis (ICAS) and extracranial atherosclerotic stenosis (ECAS).MethodsThis study analyzed correlation between non-traditional lipid parameters and moderate-to-severe ICAS and ECAS concerning stenosis location, distribution, and the presence or absence of symptoms. Logistic models and restricted spline analysis were utilized to explore the relationship between Castelli's risk index-II (CRI-II) and the occurrence of stroke events.ResultsThe present study comprised 1,030 participants, of whom 143 were non-stenotic and 887 were patients with moderate-to-severe stenosis. The study focuses on the latter and indicated statistically significant differences in AIP, LCI, RC, AC, CRI-I, and CRI-II among the three groups of ICAS, ECAS, and combined ICAS and ECAS (P = 0.012, 0.005, 0.013, 0.009, 0.009, 0.032, respectively). Lipid parameters for ICAS were generally higher than those for ECAS. Remnant cholesterol (RC) exhibited a discrepancy among the anterior, posterior, and combined anterior and posterior circulation stenosis groups (P = 0.047). Logistic regression analysis revealed that CRI-II (Odds ratio [OR] = 1.20, Confidence interval [CI] 1.03–1.40, P = 0.009) and low-density lipoprotein cholesterol (LDL-c) (OR = 1.21, CI 1.03–1.42, P = 0.011) demonstrated remarkable elevations in symptomatic stenosis patients compared to patients without symptoms. After adjusting for potential confounding factors, CRI-II remained an independent risk factor for symptomatic stenosis. Furthermore, multivariate spline regression modeling elucidated that an augmented risk of stroke events in moderate-to-severe stenosis was associated with an elevated CRI-II. As CRI-II elevated, the risk of stroke events increased progressively.https://www.frontiersin.org/articles/10.3389/fneur.2025.1564966/fullnon-traditional lipid parametersintracranial atherosclerotic stenosisextracranial atherosclerotic stenosisCastelli's risk index-IIstoke
spellingShingle Yin Fei Huang
Zhen Xing Liu
Kuan Cen
Ren Wei Zhang
Qiao Yuan Xiang
Qi Cai
Chun Jiao Yang
Lei Luo
Hai Long Xu
Yu Xie
Yu Min Liu
Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
Frontiers in Neurology
non-traditional lipid parameters
intracranial atherosclerotic stenosis
extracranial atherosclerotic stenosis
Castelli's risk index-II
stoke
title Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
title_full Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
title_fullStr Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
title_full_unstemmed Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
title_short Non-traditional lipid parameters are independent predictors of the location, distribution, and stroke events of moderate-to-severe intracranial and extracranial atherosclerotic stenosis
title_sort non traditional lipid parameters are independent predictors of the location distribution and stroke events of moderate to severe intracranial and extracranial atherosclerotic stenosis
topic non-traditional lipid parameters
intracranial atherosclerotic stenosis
extracranial atherosclerotic stenosis
Castelli's risk index-II
stoke
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1564966/full
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