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Background <p>Alterations in thyroid function, inflammatory responses, and lipid metabolism have been reported in patients with acute ischemic stroke (AIS). However, the relationships between these biological changes and short-term functional outcomes, particularly in the context of thyroid dysfunction, remain incompletely understood.</p> Methods <p>This single-center retrospective cohort study included 261 patients with AIS admitted between January 2018 and December 2023. Thyroid function was assessed at admission, and patients were categorized into thyroid dysfunction (TD) and non-thyroid dysfunction (non-TD) groups. Short-term functional outcome was evaluated using the modified Rankin Scale (mRS) at 30 days. Thyroid-related indices, inflammatory cytokines, and ceramide levels obtained at admission were included in the analyses. Associations between these biomarkers and poor short-term outcome (mRS 4–6) were examined using multivariable logistic regression analyses, stratified by thyroid function status.</p> Results <p>In the overall multivariable model, FT3 (aOR 1.19, 95% CI 1.04–1.43), Cer18:0 (aOR 1.51, 95% CI 1.18–2.21), and Cer24:1 (aOR 1.18, 95% CI 1.10–1.26) were independently associated with poor 30-day functional outcome. IL-17&#xa0;A (aOR 1.37, 95% CI 1.20–1.58) and TNF-α (aOR 1.44, 95% CI 1.24–1.68) were also associated with poor outcome, whereas IL-10 showed an inverse association (aOR 0.68, 95% CI 0.59–0.78). Stratified analyses suggested differences according to thyroid dysfunction status. In the thyroid dysfunction group, FT3 was more strongly associated with poor outcome (aOR 2.33, 95% CI 1.68–4.37), whereas Cer18:0 remained positively associated in the non-thyroid dysfunction group (aOR 2.84, 95% CI 1.66–3.83).</p> Conclusion <p>In this retrospective cohort of patients with acute ischemic stroke, 30-day functional outcome was associated with thyroid-related measures, inflammatory cytokines, and ceramides after multivariable adjustment. Differences according to thyroid dysfunction status may reflect coordinated changes across thyroid function, immune-inflammatory responses, and sphingolipid metabolism in the acute post-stroke setting. These findings should be interpreted cautiously and require confirmation in larger prospective studies.</p>

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Associations of thyroid function, inflammatory cytokines, and ceramides with 30-day functional outcome after acute ischemic stroke

  • 期刊论文

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  • 发表日期：

    2026年3月17日

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  • Dayong Shen,
  • Jin Tian,
  • Wei Zhang,
  • Jun Chen,
  • Wei Zhang,
  • Long Yang

摘要

Background

Alterations in thyroid function, inflammatory responses, and lipid metabolism have been reported in patients with acute ischemic stroke (AIS). However, the relationships between these biological changes and short-term functional outcomes, particularly in the context of thyroid dysfunction, remain incompletely understood.

Methods

This single-center retrospective cohort study included 261 patients with AIS admitted between January 2018 and December 2023. Thyroid function was assessed at admission, and patients were categorized into thyroid dysfunction (TD) and non-thyroid dysfunction (non-TD) groups. Short-term functional outcome was evaluated using the modified Rankin Scale (mRS) at 30 days. Thyroid-related indices, inflammatory cytokines, and ceramide levels obtained at admission were included in the analyses. Associations between these biomarkers and poor short-term outcome (mRS 4–6) were examined using multivariable logistic regression analyses, stratified by thyroid function status.

Results

In the overall multivariable model, FT3 (aOR 1.19, 95% CI 1.04–1.43), Cer18:0 (aOR 1.51, 95% CI 1.18–2.21), and Cer24:1 (aOR 1.18, 95% CI 1.10–1.26) were independently associated with poor 30-day functional outcome. IL-17 A (aOR 1.37, 95% CI 1.20–1.58) and TNF-α (aOR 1.44, 95% CI 1.24–1.68) were also associated with poor outcome, whereas IL-10 showed an inverse association (aOR 0.68, 95% CI 0.59–0.78). Stratified analyses suggested differences according to thyroid dysfunction status. In the thyroid dysfunction group, FT3 was more strongly associated with poor outcome (aOR 2.33, 95% CI 1.68–4.37), whereas Cer18:0 remained positively associated in the non-thyroid dysfunction group (aOR 2.84, 95% CI 1.66–3.83).

Conclusion

In this retrospective cohort of patients with acute ischemic stroke, 30-day functional outcome was associated with thyroid-related measures, inflammatory cytokines, and ceramides after multivariable adjustment. Differences according to thyroid dysfunction status may reflect coordinated changes across thyroid function, immune-inflammatory responses, and sphingolipid metabolism in the acute post-stroke setting. These findings should be interpreted cautiously and require confirmation in larger prospective studies.