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Serum Levels of HDL Cholesterol are Associated with Diffuse Axonal Injury in Patients with Traumatic Brain Injury

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Abstract

Background

It is well known that lipids are vital for axonal myelin repair. Diffuse axonal injury (DAI) is characterized by widespread axonal injury. The association between serum lipids and DAI is not well known. The purpose of this study was to investigate the associations of serum lipid profile variables (triglycerides, high- and low-density lipoproteins, and total cholesterol) with DAI detected by magnetic resonance imaging (MRI) and with clinical outcome for patients suffering from traumatic brain injury (TBI).

Methods

This study included 176 patients with a history of TBI who had undergone initial serum lipid measurements within 1 week and brain MRIs within 30 days. Based on MRI findings, patients were divided into negative and positive DAI groups.

Results

Of the 176 patients, 70 (39.8%) were assigned to DAI group and 106 (60.2%) patients to non-DAI group. Compared with the non-DAI group, patients with DAI had significantly lower levels of high-density lipoprotein cholesterol (HDL-C) in serum during the first week following TBI. Multivariate analysis identified HDL-C as an independent predictor of DAI. Patients with lower serum HDL-C levels were less likely to regain consciousness within 6 months in TBI patients with DAI lesions identified by MRI.

Conclusions

Plasma levels of HDL-C may be a viable addition to biomarker panels for predicting the presence and prognosis of DAI on subsequent MRI following TBI.

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Funding

This study was supported by the National Natural Science Foundation of China (Grant No. 81802250) and the Presidential Foundation of Nanfang Hospital (Grant No. 2017C031).

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou North Road, Guangzhou, 510515, Guangdong Province, China

    Yu H. Zhong, Bi E. Zheng, Ren H. He, Zhou Zhou, Sheng Q. Zhang, Yi Wei & Jian Z. Fan

Authors
  1. Yu H. Zhong
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  2. Bi E. Zheng
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  3. Ren H. He
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  4. Zhou Zhou
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  5. Sheng Q. Zhang
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  6. Yi Wei
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  7. Jian Z. Fan
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Contributions

ZYH contributed to the study design, data collection, data analysis and interpretation, and critical writing of the manuscript. BZ contributed to data analysis and interpretation, and critical writing of the manuscript. RHH contributed to the data collection and critical appraisal of the manuscript. ZZ contributed to the data collection and critical appraisal of the manuscript. SQZ contributed to the data analysis and interpretation. YW contributed to the data collection and interpretation. JZF contributed to critical appraisal of the manuscript.

Corresponding author

Correspondence to Yu H. Zhong.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethical Approval

Since all data were extracted from routine hospital records and fully anonymized before analysis, the need for formal review and consent was waived. This study was carried out in accordance with the recommendations of Nanfang Hospital, Southern Medical University. The protocol was approved by our Institutional Review Board.

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Zhong, Y.H., Zheng, B.E., He, R.H. et al. Serum Levels of HDL Cholesterol are Associated with Diffuse Axonal Injury in Patients with Traumatic Brain Injury. Neurocrit Care 34, 465–472 (2021). https://doi.org/10.1007/s12028-020-01043-w

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  • DOI: https://doi.org/10.1007/s12028-020-01043-w

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