Objective:

To investigate the relationship between diabetes duration and specialized pro-resolving lipid mediator profiles in patients with large artery atherosclerotic stroke and their correlation with functional outcomes at three months.

Approach:

• Study Design: A single-center retrospective study involving 175 patients with LAA stroke.
• Measurements: Serum levels of LXA4, LTB4, and RvD2 were measured within 72 hours of stroke onset.
• Outcome Assessment: Functional outcomes at three months were assessed using the modified Rankin Scale.
• Data Analysis: Logistic regression and linear support vector machine models were used for exploratory analyses.

Key Findings:

• 130 patients had a favorable outcome, while 45 had a poor outcome.
• LXA4 levels were higher in the favorable-outcome group, but the difference was not statistically significant.
• No significant differences in LXA4, LTB4, or RvD2 were found between patients with and without T2DM.
• In the T2DM subgroup, patients with diabetes duration of ≥5 years had higher LXA4 and LTB4 levels and a lower RvD2/LTB4 ratio compared to those with <5 years.
• Diabetes duration positively correlated with LXA4 and LTB4 levels, but these findings are exploratory.

Interpretation:

Diabetes duration may better reflect metabolic-inflammatory heterogeneity in LAA stroke than diabetes status alone, with LXA4 as a potential candidate signaling molecule for further investigation, based on exploratory findings.

Limitations:

• Findings are exploratory and not statistically significant for LXA4's association with functional outcomes.
• No independent prognostic value for LXA4 has been established.

Conclusion:

The study suggests that diabetes duration influences lipid mediator profiles in LAA stroke, but these findings are exploratory and warrant further research.