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Introduction <p>Several studies indicate that individuals with acute ischemic stroke (AIS) who have low levels of serum albumin (SA) have a dismal prognosis. However, intravenously administering albumin 25% at a dose of 2&#xa0;g/kg did not lead to improved outcomes for patients with AIS after 90&#xa0;days. Our objective was to examine the possible correlation between SA levels and stroke outcomes in a prospective cohort investigation.</p> Methods <p>The research included a total of 5111 participants diagnosed with AIS. The correlation between SA level and modified Rankin Scale (mRS) scores 90&#xa0;days after onset was examined via univariate and multivariate logistic analyses. The relationships were examined employing&#xa0;restricted cubic splines. An investigation was conducted to ascertain&#xa0;the connection&#xa0;between SA levels and neurological functional results by employing&#xa0;mediation analysis, with the mediation impact of low-density lipoprotein (LDL) taken into account. In addition, the subgroup analyses were performed using the logistic regression.</p> Results <p>The connection&#xa0;between levels of SA&#xa0;and neurological functional outcomes following AIS exhibited a U-shaped pattern. The likelihood of a negative result dropped significantly with an elevation&#xa0;in SA (per&#xa0;g/L: OR (odds ratio) 0.88; 95%&#xa0;CI (confidence interval) 0.847–0.913) among individuals with SA levels below 42.2&#xa0;g/L. Conversely, the likelihood of a negative outcome rose with an increase in SA (per&#xa0;g/L: OR 1.033, 95%&#xa0;CI 1.009–1.058) among people with SA levels of 42.2&#xa0;g/L or above. Comparable findings were seen for mortality outcomes. A mediation study revealed that LDL&#xa0;had a mediating function in the statistical connection between SA&#xa0;levels and neurological functional outcomes, accounting for 12.3% of the connection. No significant&#xa0;interactions were seen in any of the groupings.</p> Conclusion <p>Among patients with AIS, there was a U-shaped relationship between SA levels at admission and the likelihood of poor outcomes, which was partially mediated by LDL.</p> <p>There is a Graphical Abstract available for this article.</p> Graphical Abstract <p></p>

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U-Shaped Relationship of Serum Albumin and Neurological Functional Outcomes After Acute Ischemic Stroke: A Prospective Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月16日

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  • Yuan Zhu,
  • Gang Xue,
  • Shufan Xu,
  • Qi Qin,
  • Peian Liu,
  • Lianhong Ji,
  • Huimin Wu,
  • Minghua Wu,
  • Zhuyuan Fang

摘要

Introduction

Several studies indicate that individuals with acute ischemic stroke (AIS) who have low levels of serum albumin (SA) have a dismal prognosis. However, intravenously administering albumin 25% at a dose of 2 g/kg did not lead to improved outcomes for patients with AIS after 90 days. Our objective was to examine the possible correlation between SA levels and stroke outcomes in a prospective cohort investigation.

Methods

The research included a total of 5111 participants diagnosed with AIS. The correlation between SA level and modified Rankin Scale (mRS) scores 90 days after onset was examined via univariate and multivariate logistic analyses. The relationships were examined employing restricted cubic splines. An investigation was conducted to ascertain the connection between SA levels and neurological functional results by employing mediation analysis, with the mediation impact of low-density lipoprotein (LDL) taken into account. In addition, the subgroup analyses were performed using the logistic regression.

Results

The connection between levels of SA and neurological functional outcomes following AIS exhibited a U-shaped pattern. The likelihood of a negative result dropped significantly with an elevation in SA (per g/L: OR (odds ratio) 0.88; 95% CI (confidence interval) 0.847–0.913) among individuals with SA levels below 42.2 g/L. Conversely, the likelihood of a negative outcome rose with an increase in SA (per g/L: OR 1.033, 95% CI 1.009–1.058) among people with SA levels of 42.2 g/L or above. Comparable findings were seen for mortality outcomes. A mediation study revealed that LDL had a mediating function in the statistical connection between SA levels and neurological functional outcomes, accounting for 12.3% of the connection. No significant interactions were seen in any of the groupings.

Conclusion

Among patients with AIS, there was a U-shaped relationship between SA levels at admission and the likelihood of poor outcomes, which was partially mediated by LDL.

There is a Graphical Abstract available for this article.

Graphical Abstract