Metabolic alterations in the serum of patients with acute ischemic stroke

Ischemic stroke (IS) occurs when a clot obstructs cerebral blood flow, leading to potentially irreversible damage. Metabolites, as the end products of cellular metabolism, can reflect pathological changes in the body. This study aimed to characterize serum metabolic alterations associated with acute ischemic stroke. Participants were divided into discovery and validation sets, each comprising healthy controls and IS patients. In the discovery set, untargeted serum metabolomic profiling was performed using liquid chromatography – tandem mass spectrometry. Metabolites showing significant intergroup differences were selected as biomarker candidates and quantitatively validated in the independent set. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Three metabolites – cytidine, decanoyl-L-carnitine, and 2-hydroxyestradiol – were identified as significantly altered in IS patients. Cytidine and 2-hydroxyestradiol demonstrated excellent diagnostic performance (AUCs of 0.968 and 0.929, respectively), while decanoyl-L-carnitine showed good performance (AUC = 0.808). The three metabolites exhibit significant alterations in acute ischemic stroke patients and provide insight into disease-associated metabolic changes. Their validation lays the groundwork for future exploratory studies investigating potential biomarkers.