Risk Factors for Ischemic Stroke Linked to Fatty Acid Profiles and Ratios

by | Mar 20, 2023 | 2023, Brain Health, DHA, EPA (Eicosapentaenoic Acid), Omega - 3, Polyunsaturated, Stroke

Written by Taylor Woosley, Staff Writer. Findings of the prospective observational study show that risk factors such as dyslipidemia, atrial fibrillation, and smoking are strongly connected to fatty acids. Limiting or eliminating modifiable lifestyle risk factors such as smoking or alcohol consumption can positively influence the fatty-acids profile. 

Brain HealthStroke is one the leading cause of disabilities and cognitive deficits worldwide1. A stroke is classified as ischemic or hemorrhagic based on the underlying neuropathology, with ischemic strokes accounting for 85% of all cases and is mainly caused by occlusion of the middle cerebral artery, which causes damage to the brain parenchyma in the affected area2. Stroke incidence increases with age and nearly 75% of all strokes take place in patients older than 64 years3. Risk factors include atrial fibrillation, hypertension, hyperlipidemia, diabetes, smoking, lack of physical activity, unhealthy diet, and alcohol consumption4.

Research has indicated that adherence to a healthy diet with an increased intake of polyunsaturated fatty acids (PUFAs) may be of importance for reduction of ischemic stroke risk5. The composition of fatty acids in the diet has been found to affect lipidic directly as well as glycemic metabolism, aggregation, and erythrocyte deformation, consequently affecting blood pressure values6. Furthermore, omega-3 PUFAs, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), represent the precursors of lipid mediators that can have a positive influence on the resolution of atherosclerotic inflammation by reducing the synthesis of proinflammatory lipid mediators7.

Andone et al. conducted a prospective observational study to establish the correlations between risk factors and fatty-acids profile to create a baseline of reference for future studies to aid in addressing specific risk factor prevention actions. Subjects (n=274), consisting of 143 (52.5%) male and 131 (47.8%) female participants, with a mean age of 70.53 ± 12.63 years partook in the study. All participants included were diagnosed with acute ischemic stroke. Peripheral blood samples were obtained to determine fatty acids profile (arachidonic acid (AA), DHA, and EPA) in the first 24 hours from admission. Statistical analyses consisted of an assessment of parametric variables (ANOVA test), describing the data as continuous, depending on the distribution. Contingency tables and the Chi2 test were utilized to assess the correlation between the distributions of the categorical variables.

Statistically significant differences between the EPA/DHA ratio (p = 0.008) and DHA/EPA ratio (p = 0.002) were noted between male and female patients. Significant findings of the study are as follows:

  • Regarding dyslipidemia, statistically significant differences in all three fatty acids: AA (p = 0.033), DHA (p = 0.003), and EPA (p = 0.006) were observed. Between female and male subjects, observed differences in the serum levels of DHA (p = 0.021) as well as DHA/AA ratio (p = 0.009), EPA/DHA ratio (p = 0.012), DHA/EPA ratio (p = 0.023) and (DHA + EPA)/AA ratio (p = 0.029) were noted.
  • In participants with recurrent stroke with hypertension, the mean age was 72.97 ±46 years, while the recurrent stroke patients without hypertension had a mean age of 39.33 ± 14.01, an extremely statistically significant difference (p < 0.001). In the recurrent-stroke patients’ groups based on dyslipidemia, statistically significant differences between the serum values of AA (p = 0.022), DHA (p = 0.004), EPA (p = 0.012) and between their ratios DHA/AA (p = 0.022), EPA/AA (p = 0.029), (DHA + EPA)/AA (p = 0.017) was noted.
  • In the participants’ group with no previous-stroke history, differences regarding mean age when grouped by sex (p = 0.001), hypertension (p < 0.001), atrial fibrillation (p < 0.001), chronic kidney disease (p = 0.001), smoking (p < 0.001) and chronic alcohol consumption (p = 0.015) were observed.

Results of the study suggest that some risk factors such as dyslipidemia and atrial fibrillation have strong correlations with the levels of fatty acids and their ratios. Decreasing or limiting modifiable lifestyle risk factors may positively influence the fatty-acids profile and omega-3 and omega-6 ratios in subjects with ischemic stroke. Study limitations include lack of evaluating other fatty acids which would provide more insight and the need for a future study to represent a comparison between fatty-acid profiles in subjects with ischemic stroke with a control group.

Source: Andone, Sebastian, Lénárd Farczádi, Silvia Imre, Zoltan Bajko, Anca Moțățăianu, Smaranda Maier, Laura Bărcuțean, and Rodica Bălașa. “Serum Fatty Acids Are Associated with a Higher Risk of Ischemic Stroke.” Nutrients 15, no. 3 (2023): 585.

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Click here to read the full text study.

Posted March 20, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Zhao Y, Zhang X, Chen X, Wei Y. Neuronal injuries in cerebral infarction and ischemic stroke: From mechanisms to treatment (Review). Int J Mol Med. Feb 2022;49(2)doi:10.3892/ijmm.2021.5070
  2. Pluta R, Januszewski S, Czuczwar SJ. The Role of Gut Microbiota in an Ischemic Stroke. Int J Mol Sci. Jan 18 2021;22(2)doi:10.3390/ijms22020915
  3. Maida CD, Norrito RL, Daidone M, Tuttolomondo A, Pinto A. Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches. Int J Mol Sci. Sep 4 2020;21(18)doi:10.3390/ijms21186454
  4. Paul S, Candelario-Jalil E. Emerging neuroprotective strategies for the treatment of ischemic stroke: An overview of clinical and preclinical studies. Exp Neurol. Jan 2021;335:113518. doi:10.1016/j.expneurol.2020.113518
  5. Venø SK, Schmidt EB, Bork CS. Polyunsaturated Fatty Acids and Risk of Ischemic Stroke. Nutrients. Jun 27 2019;11(7)doi:10.3390/nu11071467
  6. Andone S, Farczádi L, Imre S, et al. Serum Fatty Acids Are Associated with a Higher Risk of Ischemic Stroke. Nutrients. Jan 22 2023;15(3)doi:10.3390/nu15030585
  7. Tułowiecka N, Kotlęga D, Prowans P, Szczuko M. The Role of Resolvins: EPA and DHA Derivatives Can Be Useful in the Prevention and Treatment of Ischemic Stroke. Int J Mol Sci. Oct 15 2020;21(20)doi:10.3390/ijms21207628