AUTHOR=Van Tuyen Nguyen , Hoang Ngoc Nguyen , Quoc Hoan Phan , Thi Yen Nguyen , Hoan Nghiem Xuan , Cam Thach Nguyen 

TITLE=Differential distribution of plasma apoA-I and apoB levels and clinical significance of apoB/apoA-I ratio in ischemic stroke subtypes

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1398830

DOI=10.3389/fneur.2024.1398830

ISSN=1664-2295

ABSTRACT=Background and purpose: Ischemic stroke (IS) is classified into clinical subtypes and likely influenced by various lipid components. Nevertheless, the roles of apolipoprotein A-I (apoA-I), apolipoprotein B (apoB), and apoB/apoA-I ratio in different IS subtypes remain underexplored. This study aimed to investigate the differential distribution of plasma apoA-I and apoB levels among IS subtypes and to evaluate the predictive value of the apoB/apoA-I ratio in assessing IS subtypes and disease severity. Methods: In this study, 406 IS patients were categorized into three IS-subtypes based on clinical manifestations and imaging assessment, including intracranial atherosclerosis-related IS patients (ICAS, n=193), extracranial atherosclerosis-related IS patients (ECAS, n=111), and small artery occlusion-related IS patients (SAO, n=102).Plasma apoA-I and apoB levels were measured upon hospital admission. Random forest (RF) models were performed to assess predictive values of these apolipoproteins apoB, apoA-I and their ratio in assessing IS subtype stratification and disease severity.Results: Serum apoA-I levels were significantly lower in ICAS compared to ECAS and SAO patients (p<0.0001), while apoB levels were higher in ICAS patients (p<0.0001).The apoB/apoA-I ratio was significantly higher in ICAS compared to ECAS and SAO patients (p<0.0001). Correlation analyses found a significant correlation between the apoB/apoA-I ratio and conventional lipid components. Additionally, RF models and plots of variable importance and distribution of minimal depth revealed that the apoB/apoA-I ratio played the most influential predictor in predicting IS subtypes and stenosis severity.Our study shows the differential distribution of apoA-I and apoB IS subtypes and reveals the significance of the apoB/apoA-I ratio in assessing IS subtypes and arterial stenosis severity. Further studies are warranted to validate these findings and enhance their clinical applicability.