Lipid metabolism in patients with vascular myelopathy

   Background. Vascular myelopathy (spinal cord infarct) remains a diagnostically challenging condition with a high risk of disability. The pathogenetic role of lipid metabolism disorders in this condition remains poorly understood.

   The aim of the study was to evaluate laboratory parameters of lipid metabolism and atherogenesis in patients with vascular myelopathy and to determine their possible relationship with the period of the disease and functional outcomes.

   Material and methods. A single-center comparative study included 177 patients divided into two groups: the main group included 77 patients with confi rmed spinal cord infarct, the comparison group included 100 patients with non-vascular myelopathies. All participants underwent comprehensive laboratory testing, including lipid profile (total cholesterol, triglycerides, LDL, VLDL, HDL), lipoprotein(a) and adiponectin. Functional outcome at the end of the follow-up period was assessed using the modified Rankin Scale.

   Results. Patients in the main group showed a statistically signifi cant atherogenic profile: elevated triglycerides (1.66 [1.15; 2.54] vs 1.22 [0.90; 1.58] mmol/L, p < 0.0001), VLDL (0.94 [0.60; 1.50] vs 0.70 [0.47; 0.78] mmol/L, p < 0.0001) and lipoprotein(a) (0.48 [0.32; 0.60] vs 0.10 [0.05; 0.17] g/L, p < 0.0001), along with decreased HDL (1.32 ± 0.34 vs 1.54 ± 0.33 mmol/L, p < 0.0001) and adiponectin (1.63 [1.51; 1.87] vs 2.04 [1.93; 2.20] pg/mL, p < 0.0001). No statistically signifi cant differences in the studied parameters were found between subgroups with favorable and unfavorable functional outcomes, as well as in subgroups based on the duration of vascular myelopathy.

   Conclusion. The results of the study indicate the presence of a pronounced atherogenic profile in patients with vascular myelopathy. Although a direct correlation between the identified changes and functional outcomes did not reach statistical signifi cance, the data obtained highlight the potential role of lipid disorders in the pathogenesis of spinal cord infarction. These results indicate the need to include an extended lipid profi le in the diagnostic algorithm of this patient’s category to improve diagnosis and secondary prevention approaches.

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