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. 2025 Sep 3:23969873251367250.
doi: 10.1177/23969873251367250. Online ahead of print.

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

Iolanda Lázaro  1   2   3 , Leila Luján-Barroso  4 , Natalia Soldevila-Domenech  1 , Antonio J Amor  5 , Emilio Ortega  3   5   6 , Emilio Ros  3   7 , Maria-José Sánchez  8   9   10 , Miguel Rodríguez-Barranco  8   9   10 , Maria Dolores Chirlaque  10   11   12 , José Maria Huerta  10   11 , Marcela Guevara  10   13   14 , Conchi Moreno-Iribas  10   13   14 , Catalina Bonet  4 , Helmut Schröder  1   10 , Montserrat Fitó  1   3 , Nathan L Tintle  15   16 , Nathan Ryder  16 , William S Harris  16   17 , Antonio Agudo  4 , Aleix Sala-Vila  1   2   3   16
Affiliations

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

Iolanda Lázaro et al. Eur Stroke J. .

Abstract

Introduction: 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.

Patients and methods: 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).

Results: 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).

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

Keywords: Biomarkers; diet; fatty acids; lifestyle; nutrition.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ER reports grants, personal fees, non-financial support, and other from the California Walnut Commission (CWC), during the conduct of the study; grants, personal fees, non-financial support and other from Alexion; personal fees and other from Sociedad Española de Arteriosclerosis outside the submitted work. W.S.H. holds stock in OmegaQuant Analytics, a laboratory that offers omega-3 testing for researchers, clinicians, and the public. AS-V has received research funding through his institution and support to attend professional meetings from the CWC. Other authors report no conflict of interest.

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