High Density Lipoprotein (HDL) Level and Blood Urea Nitrogen (BUN)/Creatinin Ratio Relationship with One-Month Outcome in Acute Ischemic Stroke Patients

Ilham Habib Djarkoni; Muhammad Iqbal Basri; Muhammad Akbar; Firdaus Hamid; Andi Kurnia Bintang; Jumraini Tamasse

doi:10.47353/jsocmed.v2i12.112

High Density Lipoprotein (HDL) Level and Blood Urea Nitrogen (BUN)/Creatinin Ratio Relationship with One-Month Outcome in Acute Ischemic Stroke Patients

Ilham Habib Djarkoni
Neurology Resident in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Muhammad Iqbal Basri
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Muhammad Akbar
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Firdaus Hamid
Teaching Staff, Consultant Microbiologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Andi Kurnia Bintang
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia
Jumraini Tamasse
Teaching Staff, Consultant Neurologist in Medical Faculty, Hasanuddin University, Makassar, Indonesia

Abstract

Introduction: Stroke has caused around 15.5% of all deaths. Evaluation of factors that worsen clinical outcomes is necessary to avoid complications such as renal dysfunction and secondary dyslipidaemia. This study aims to determine the relationship between increasing serum HDL levels and blood urea nitrogen–serum creatinine ratio (BUN/Cr) on clinical outcomes of acute ischemic stroke.

Method: Prospective cohort study was used with subjects being first-onset acute ischemic stroke patients. Demographic, clinical data, and assessment of BUN/Cr and HDL ratios were collected. Subjects were divided into good clinical outcome (mRS 0-2) and poor clinical outcome (mRS 3-6) groups, and then analysed using multiple linear regression multivariate analysis with confidence interval of 95%.

Results: 60 participants met the inclusion criteria. There was a significant relationship between serum BCR levels and poor clinical outcomes (p <0.001) relationship between serum HDL levels and poor clinical outcomes also shown significances (p <0.001) Mean BCR in good and poor clinical outcomes of acute ischemic stroke were (17.08±30.13) and (29.35±67.30) respectively. Mean HDL in good and poor clinical outcomes were (39± 62) and (41 ± 92) respectively. A multiple linear regression analysis showed a positive correlation (p <0.001) between increasing Serum HDL levels and Bun/Cr ratio simultaneously to poor clinical outcomes in acute ischemic stroke patients. The Cut-off point was 20.9 for BUN to creatinine ratio and 46 mg/dL at serum HDL. Both of BUN/Cr ratio and HDL were shown high specificity and could be used as predictors of clinical outcome in acute ischemic stroke patients.

Conclusion: Increased BUN/Cr ratio and increased serum HDL levels were associated with clinical outcomes in patients with acute ischemic stroke.

Similar Articles

Kadek Adi Sudarmika, Ni Luh Eka Sriayu Wulandari, Dilated Cardiomyopathy Related to Hyperthyroidism in Young Adults , Journal of Society Medicine: Vol. 3 No. 8 (2024): August

<< < 1 2 3 4

You may also start an advanced similarity search for this article.

PDF

Published at

31. December 2023
https://doi.org/10.47353/jsocmed.v2i12.112
Issue:

Vol. 2 No. 12 (2023): December
Section:

Articles
Keywords:

Stroke BUN/Cr ratio Creatinine HDL mRS
References:

Lin LC, Yang JT, Weng HH, Hsiao CT, Lai SL, Fann WC. Predictors of early clinical deterioration after acute ischemic stroke. Am J Emerg Med. 2011; 29(6): 577-81.

Deng L, Wang C, Qiu S, Bian H, Wang L, Li Y. et al. Association between Blood Urea Nitrogen-to-creatinine Ratio and Three-Month Outcome in Patients with Acute Ischemic Stroke. Curr Neurovasc Res. 2019; 16: 166-72.

Ovbiagele B, Bath PM, Cotton D. Low glomerular filtration rate, recurrent stroke risk, and effect of renin-angiotensin system modulation. Stroke. 2013; 44: 3223-5.

Bowe B, Xie Y, Xian H, Balasubramanian S, Al-Aly Z. Low levels of high-density lipoprotein cholesterol increase the risk of incident kidney disease and its progression. Kidney Int. 2016; 89: 886-96.

Aliah A, Kuswara F, Limoa A, Wuysang G. Gambaran umum tentang gangguan peredaran darah otak. Dalam Kapita Selekta Neurologi. Gadjah Mada Press. 2007

Akbar M, Misbach J, Susatia F, Rasyid A, Alfa AY, Syamsudin T. et al. Clinical features of transient ischemic attack or ischemic stroke patients at high recurrence risk in Indonesia. Neurology Asia. 2018; 23:107–13.

Lu J, Han G, Liu X, ChenB, Peng K, Shi Y. et al. Association of high-density lipoprotein cholesterol with all-cause and cause-specific mortality in a Chinese population of 3.3 million adults: a prospective cohort study. The Lancet Regional Health - Western Pacific. 2023; 1: 1-10.

Li H, Qian F, Zuo Y, Yuan J, Chen S, Wu S. et al. U-Shaped Relationship of High-Density Lipoprotein Cholesterol and Incidence of Total, Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study. Stroke. 2022; 53: 1624-32.

Moradi H, Streja E, Kashyap ML, Vaziri ND, Fonarow GC, Zadeh KK. Elevated high-density lipoprotein cholesterol and cardiovascular mortality in maintenance hemodialysis patients. Nephrology Dialysis Transplantation. 2014; 29: 1554-62.

Qi Y, Fan J, Liu J, Wang W, Wang M, Sun J. et al. Cholesterol-Overloaded HDL Particles Are Independently Associated With Progression of Carotid Atherosclerosis in a Cardiovascular Disease-Free Population: A Community-Based Cohort Study. Journal of the American College of Cardiology. 2015; 65: 355-63

Huang CY, Lin FY, Shih CM, Au HK, Chang YJ, Nakagami H. et al. Density Lipoprotein From Healthy Subjects Paradoxically Impair Human Endothelial Progenitor Cells and Related Angiogenesis by Activating Rho-Associated Kinase Pathways. Thromb Vasc Biol. 2012; 32: 2405-17

Trimarco V, Izzo R, Morisco C, Mone P, Virginia Manzi M, Falco A. et al. High HDL (High-Density Lipoprotein) Cholesterol Increases Cardiovascular Risk in Hypertensive Patients. Hypertension. 2022; 79 (10): 2355-63.

Kim H, Lee K, Choi HA, Samuel S, Park JH, Jo KW. Elevated blood urea nitrogen/creatinine ratio is associated with venous thromboembolism in patients with acute ischemic stroke. J Korean Neurosurg Soc 2017; 60: 620-6

Bahouth MN, Gottesman RF, Szanton SL. Primary 'dehydration' and acute stroke: A systematic research review. J Neurol. 2018; 265: 2167-81.

Hillis AE, Ulatowski JA, Barker PB. A pilot randomized trial of induced blood pressure elevation: Effects on function and focal perfusion in acute and subacute stroke. Cerebrovasc Dis. 2003; 16: 236-46.

Ginsberg MD. Expanding the concept of neuroprotection for acute ischemic stroke: The pivotal roles of reperfusion and the collateral circulation. Prog Neurobiol. 2016; 145: 46-77.

Nagayama D, Watanabe Y, Yamaguchi T, Fujishiro K, Suzuki K, Shirai K. et al. Relationship of serum lipid parameters with kidney function decline accompanied by systemic arterial stiffness: a retrospective cohort study, Clinical Kidney Journal. 2023; 16: 2289-98.
Share:

Z

Habib Djarkoni, I., Iqbal Basri, M., Akbar, M., Hamid, F., Kurnia Bintang, A., & Tamasse, J. (2023). High Density Lipoprotein (HDL) Level and Blood Urea Nitrogen (BUN)/Creatinin Ratio Relationship with One-Month Outcome in Acute Ischemic Stroke Patients. Journal of Society Medicine, 2(12), 417–424. https://doi.org/10.47353/jsocmed.v2i12.112