Assessment of the relationship between AHR, sdLDL, Klotho biomarkers, and etiologic subtypes in young to middle-aged acute ischemic stroke according to toast classification.
The incidence of acute ischemic stroke (AIS) is increasing among young to middle-aged adults (18-64 years), posing substantial socioeconomic and healthcare challenges. This study aimed to evaluate the diagnostic and predictive value AHR, Klotho, and sdLDL-C in AIS and across different TOAST etiological subtypes in this age group.
We retrospectively enrolled young to middle-aged patients with first-ever AIS and age- and sex-matched stroke-free controls. All participants underwent DWI and additional vascular assessments, including MRA, CTA, and/or DSA. Clinical characteristics, imaging findings, and laboratory parameters were statistically analyzed. Patients were classified into TOAST subtypes for etiological analysis.
Multivariate logistic regression identified male sex, DBP, FPG, LDL-C, and DWM as independent risk factors for AIS. The most common TOAST subtype was SAO, followed by SUE and LAA. Compared to controls, AIS patients exhibited significantly higher AHR and sdLDL-C levels and lower Klotho levels (all P < 0.001). ROC analysis demonstrated that the combined use of AHR, Klotho, and sdLDL-C had high diagnostic accuracy for AIS (AUC = 0.971), with the highest predictive value observed for LAA subtype (AUC > 0.9).
In young to middle-aged adults, male sex, elevated DBP, FPG, LDL-C, and DWM are independent risk factors for AIS. AHR and sdLDL-C are positively associated with AIS risk, while Klotho is inversely associated. The combined biomarker panel (AHR, Klotho, and sdLDL-C) demonstrates strong diagnostic utility, particularly for identifying the LAA subtype. These findings provide valuable insight into early risk stratification and classification of AIS in younger populations.
We retrospectively enrolled young to middle-aged patients with first-ever AIS and age- and sex-matched stroke-free controls. All participants underwent DWI and additional vascular assessments, including MRA, CTA, and/or DSA. Clinical characteristics, imaging findings, and laboratory parameters were statistically analyzed. Patients were classified into TOAST subtypes for etiological analysis.
Multivariate logistic regression identified male sex, DBP, FPG, LDL-C, and DWM as independent risk factors for AIS. The most common TOAST subtype was SAO, followed by SUE and LAA. Compared to controls, AIS patients exhibited significantly higher AHR and sdLDL-C levels and lower Klotho levels (all P < 0.001). ROC analysis demonstrated that the combined use of AHR, Klotho, and sdLDL-C had high diagnostic accuracy for AIS (AUC = 0.971), with the highest predictive value observed for LAA subtype (AUC > 0.9).
In young to middle-aged adults, male sex, elevated DBP, FPG, LDL-C, and DWM are independent risk factors for AIS. AHR and sdLDL-C are positively associated with AIS risk, while Klotho is inversely associated. The combined biomarker panel (AHR, Klotho, and sdLDL-C) demonstrates strong diagnostic utility, particularly for identifying the LAA subtype. These findings provide valuable insight into early risk stratification and classification of AIS in younger populations.