Observational studyNeurology2026
Metabolic Markers of MRI-Confirmed Lacunar Stroke: Observational and Mendelian Randomization Analyses.
Observational study in Neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesLacunar stroke results from cerebral small vessel disease (SVD) and is a major cause of vascular dementia and cognitive decline. We aimed to evaluate the associations of metabolites with lacunar stroke, neuroimaging markers of SVD, and cognition to help elucidate SVD pathogenesis.
methodsIn a clinical cohort of MRI-confirmed lacunar stroke cases and unrelated hospital controls recruited from stroke centers across the United Kingdom, we assayed 250 serum metabolites using NMR spectroscopy. We investigated the association of metabolites with MRI-confirmed lacunar stroke, neuroimaging markers, and cognitive impairment. We also conducted a genome-wide association analysis for each metabolite and applied bidirectional Mendelian randomization (MR) to investigate causality.
resultsAmong 2,408 participants, there were 1,456 lacunar stroke cases (mean age, 62 [SD 12]; 34% female) and 952 controls (mean age, 57 [SD 6]; 38% female). Observational analyses identified 211 metabolites that were significantly associated with lacunar stroke. MR analyses identified significant evidence to support causal associations of 2 of these metabolites, glycine and the proportion of cholesterol to total lipids within medium low-density lipoprotein (LDL) (%C/Total in M-LDL), with 2 distinct lacunar stroke subtypes-isolated lacunar infarcts (ILI, 1 lacunar infarct with Fazekas grade <2) and multiple lacunar infarcts and/or leukoaraiosis (MLI/LA, >1 lacunar infarct and/or Fazekas grade ≥2). Glycine was inversely associated with ILI (OR: 0.704, 95% CI 0.585-0.848), and %C/Total in M-LDL was inversely associated with MLI/LA (OR: 0.541, 95% CI 0.401-0.730). Five metabolites (Total S-high-density lipoprotein [HDL], S-HDL concentration, phospholipid (PL) in S-HDL, %CE/Total in L-LDL, and lactate) were significantly associated with executive functioning and processing speed in observational analyses. MR analyses also implicated genetically determined levels of ω-3/Total FA with 2 diffusion tensor imaging markers of SVD. Overall, the most robust and consistent associations across both observational and MR analyses were identified for glycine and %C/Total in M-LDL with lacunar stroke subtypes. DISCUSSION: We identified inverse associations of glycine and the proportion of cholesterol to total lipids within medium LDL with distinct subtypes of MRI-confirmed lacunar stroke. These findings reveal metabolomics signatures associated with lacunar stroke subtypes, which may inform future studies of SVD pathogenesis and biomarker development.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.