Frontiers in neurology · 2026
Dietary background, serum polyunsaturated fatty acid profiles, and 1-year outcomes after large-artery atherosclerotic stroke: a multicenter cohort study.
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Lin Xiaoci, Zhao Zhihao, Zhu Daijun, Shen Guogu, Xu Xuri, Li Yinyan
Аннотация
OBJECTIVE: To examine whether long-term dietary background is associated with post-stroke outcomes in patients with large-artery atherosclerotic cerebral infarction (LAA-CI), and to explore the relationship between serum polyunsaturated fatty acid (PUFA) profiles and neurological, functional, and neuropsychiatric recovery.
METHODS: This retrospective multicenter cohort study enrolled 410 patients with LAA-CI admitted to the neurology departments of two hospitals in Zhejiang Province, China, between June 2022 and December 2024. Patients were stratified by long-term dietary background into a high-fish/seafood dietary group (n = 210) and a mixed/omnivorous inland dietary group (n = 200). All patients underwent 1-year follow-up with assessment of modified Rankin Scale (mRS) score, poor functional outcome (mRS > 2), change in NIHSS score (ΔNIHSS), post-stroke depression (HAMD), and post-stroke cognitive impairment (MMSE). In a representative subgroup (n = 100), serum PUFA profiling was performed by gas chromatography-mass spectrometry. Multivariable logistic and linear regression models and ordinal trend analyses were applied to quantify associations between dietary background, PUFA indices, and clinical outcomes.
RESULTS: Baseline demographic and major clinical characteristics were comparable between the two groups. At 1-year follow-up, the island group showed lower mRS scores, a lower incidence of poor functional outcomes, and greater neurological improvement (all P < 0.05), along with lower rates of post-stroke depression and cognitive impairment (all P < 0.01) compared with the inland group. In the PUFA subgroup, the island group exhibited higher ω-3 levels and lower ω-6/ω-3 ratios (both P < 0.001). Further analyses demonstrated that higher ω-6/ω-3 ratios were associated with increasing risks of poor functional outcome, post-stroke depression, and cognitive impairment (all P for trend < 0.05), and were negatively correlated with ΔNIHSS (β = -0.34, P = 0.003).
CONCLUSION: Differences in long-term dietary background are associated with heterogeneity in post-stroke recovery. The ω-6/ω-3 ratio may represent a metabolic marker linked to functional, neurological, and neuropsychiatric outcomes after stroke, with potential implications for risk stratification and follow-up management, providing a novel research direction for post-stroke risk stratification and follow-up management.
METHODS: This retrospective multicenter cohort study enrolled 410 patients with LAA-CI admitted to the neurology departments of two hospitals in Zhejiang Province, China, between June 2022 and December 2024. Patients were stratified by long-term dietary background into a high-fish/seafood dietary group (n = 210) and a mixed/omnivorous inland dietary group (n = 200). All patients underwent 1-year follow-up with assessment of modified Rankin Scale (mRS) score, poor functional outcome (mRS > 2), change in NIHSS score (ΔNIHSS), post-stroke depression (HAMD), and post-stroke cognitive impairment (MMSE). In a representative subgroup (n = 100), serum PUFA profiling was performed by gas chromatography-mass spectrometry. Multivariable logistic and linear regression models and ordinal trend analyses were applied to quantify associations between dietary background, PUFA indices, and clinical outcomes.
RESULTS: Baseline demographic and major clinical characteristics were comparable between the two groups. At 1-year follow-up, the island group showed lower mRS scores, a lower incidence of poor functional outcomes, and greater neurological improvement (all P < 0.05), along with lower rates of post-stroke depression and cognitive impairment (all P < 0.01) compared with the inland group. In the PUFA subgroup, the island group exhibited higher ω-3 levels and lower ω-6/ω-3 ratios (both P < 0.001). Further analyses demonstrated that higher ω-6/ω-3 ratios were associated with increasing risks of poor functional outcome, post-stroke depression, and cognitive impairment (all P for trend < 0.05), and were negatively correlated with ΔNIHSS (β = -0.34, P = 0.003).
CONCLUSION: Differences in long-term dietary background are associated with heterogeneity in post-stroke recovery. The ω-6/ω-3 ratio may represent a metabolic marker linked to functional, neurological, and neuropsychiatric outcomes after stroke, with potential implications for risk stratification and follow-up management, providing a novel research direction for post-stroke risk stratification and follow-up management.