# Development of a blood-based lipidomic fat quality score for the risk of ischemic stroke

## TL;DR

This study developed a blood-based score to assess fat quality and found that lower scores are linked to a higher risk of ischemic stroke.

## Contribution

A novel lipidomic fat quality score based on red blood cell fatty acids was developed and validated for ischemic stroke risk.

## Key findings

- Each 1-unit increase in the LFQ score was associated with a 14% lower odds of ischemic stroke.
- Individuals with the highest LFQ scores had a 36% lower odds of stroke compared to those with the lowest scores.
- Results were replicated in an independent cohort, showing consistent risk reduction with higher LFQ scores.

## Abstract

Poor-quality diets promote ischemic stroke. Red blood cell fatty acids (RBC-FAs) are objective, long-term biomarkers of diet. In a case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain, we developed a blood-based lipidomic fat quality (LFQ) score considering pre-defined RBC-FA diet-related biomarkers, and examined whether LFQ score relates to the risk of ischemic stroke.

We determined the RBC-FAs (n = 438 cases of incident ischemic stroke, n = 438 matched controls). For each participant, we scored 1 for each beneficial metric (C15:0+C17:0; C18:2n-6; C18:3n-3; C20:5n-3; C22:6n-3) ⩾the median of the control group; and 1 for each detrimental metric (C16:0; C16:1n-7; C18:0) <the median of the control group. LFQ score resulted from the 8-component sum (range = 0-8; higher values, higher fat quality). We explored the validity of findings in a different background (n = 2468 participants from the Framingham Offspring Study without ischemic stroke at baseline, 12-year median follow-up, n = 121 cases).

In a fully adjusted model, the Odds Ratio (OR) for ischemic stroke was 0.86 (95% confidence interval [CI] = 0.77–0.95) for each 1-unit increase of the LFQ score. Compared to individuals at the lowest category of LFQ score (0–3 points), those at the top category (5–8 points) had lower odds (OR = 0.64, 95% CI = 0.44–0.94). The findings were similar in the Framingham Offspring Study (Hazard Ratio [HR] for each 1-unit increase = 0.83; 95% CI = 0.70–0.99; HR for those at top category = 0.49; 95% CI = 0.29–0.84, compared to those at the lowest category).

Low blood-based LFQ scores relate to a high risk of ischemic stroke.

Graphical abstract