{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:51Z","timestamp":1753891551434,"version":"3.41.2"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Moyamoya disease (MMD) is a rare progressive cerebrovascular disorder with a high risk of postoperative cerebral infarction. Low-density lipoprotein (LDL) is a key risk factor for atherosclerosis, but the association between perioperative dynamic changes in LDL levels and the risk of postoperative cerebral infarction in MMD patients has not been thoroughly studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, single-center study included 266 MMD patients who underwent surgical treatment at The Affiliated Hospital of Qingdao University between 2015 and 2022. Preoperative, 24-h postoperative, and recovery-phase LDL levels (minimum, maximum, and mean) were recorded. Key variables were selected using LASSO regression, and a risk prediction model for cerebral infarction was constructed using multivariate logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 266 patients, preoperative LDL (<jats:italic>p<\/jats:italic>\u202f=\u202f0.049), postoperative LDL (<jats:italic>p<\/jats:italic>\u202f=\u202f0.027), and mean LDL during the recovery period (<jats:italic>p<\/jats:italic>\u202f=\u202f0.036) were significantly associated with the occurrence of postoperative cerebral infarction. The integrated model, combining LDL indicators and clinical variables, demonstrated excellent predictive ability (AUC\u202f=\u202f0.82) and good calibration. Decision curve analysis (DCA) further validated the model\u2019s application in clinical decision-making, indicating its effectiveness in identifying high-risk patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dynamic monitoring of LDL levels during the perioperative period is of great significance for predicting the risk of postoperative cerebral infarction in MMD patients. The constructed risk prediction model provides a scientific basis for early identification of high-risk patients and the development of individualized intervention strategies, with the potential to improve clinical management and patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1602006","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T06:54:44Z","timestamp":1748501684000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a predictive model for perioperative low-density lipoprotein as a risk factor for postoperative cerebral infarction in Moyamoya disease"],"prefix":"10.3389","volume":"16","author":[{"given":"Jinpeng","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chonghui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuiping","family":"Mu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haowen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenwen","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3153","DOI":"10.1161\/strokeaha.123.044476","article-title":"Upregulated cytoskeletal proteins promote pathological angiogenesis in Moyamoya disease","volume":"54","author":"He","year":"2023","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102281","DOI":"10.1016\/j.omtn.2024.102281","article-title":"Insights into the regulatory role of epigenetics in moyamoya disease: current advances and future prospectives","volume":"35","author":"Xu","year":"2024","journal-title":"Mol Ther Nucleic Acids"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1161\/strokeaha.123.044693","article-title":"Incidence and outcomes of posterior circulation involvement in Moyamoya disease","volume":"55","author":"Tigchelaar","year":"2024","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1227\/neu.0000000000002499","article-title":"Comparison of Bifrontal craniotomy and multiple Burr hole Encephalogaleoperiosteal-Synangiosis for pediatric Moyamoya disease: an experience of 346 patients","volume":"93","author":"Kim","year":"2023","journal-title":"Neurosurgery"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1136\/jnnp-2022-329176","article-title":"Direct versus indirect revascularization for Moyamoya: a large multicenter study","volume":"95","author":"El Naamani","year":"2024","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.jacbts.2024.10.006","article-title":"Large-scale functional characterization of low-density lipoprotein receptor gene variants improves risk assessment in cardiovascular disease","volume":"10","author":"Islam","year":"2025","journal-title":"JACC Basic Transl Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1056\/NEJMoa2405182","article-title":"Inflammation, cholesterol, lipoprotein(a), and 30-year cardiovascular outcomes in women","volume":"391","author":"Ridker","year":"2024","journal-title":"N Engl J Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1037773","DOI":"10.3389\/fendo.2023.1037773","article-title":"Prognostic value of low-density lipoprotein cholesterol in IgA nephropathy and establishment of nomogram model","volume":"14","author":"Tian","year":"2023","journal-title":"Front Endocrinol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e5","DOI":"10.1097\/scs.0000000000010585","article-title":"Two patients with ipsilateral cerebellar hemorrhage after superficial temporal artery-middle cerebral artery bypass grafting","volume":"36","author":"Yan","year":"2025","journal-title":"J Craniofac Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"571","DOI":"10.3390\/genes14081571","article-title":"Long-term LDL-apheresis treatment and dynamics of circulating miRNAs in patients with severe familial hypercholesterolemia","volume":"14","author":"Dlouha","year":"2023","journal-title":"Genes"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"151398007","DOI":"10.3389\/fneur.2024.1398007","article-title":"Vascular architecture characters and risk factors analysis of unstable moyamoya disease","volume":"15","author":"Zhao","year":"2024","journal-title":"Front Neurol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3400\/avd.oa.11.00068","article-title":"Lowered postoperative ldl-c\/hdl-C ratio reduces later cardiovascular events after abdominal aortic aneurysm surgery","volume":"5","author":"Kanaoka","year":"2012","journal-title":"Ann Vasc Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1530137","DOI":"10.3389\/fneur.2025.1530137","article-title":"Risk factors for perioperative cerebral infarction in moyamoya disease: a meta-analysis","volume":"16","author":"Wu","year":"2025","journal-title":"Front Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1161\/strokeaha.122.041932","article-title":"Five-year stroke risk and its predictors in asymptomatic Moyamoya disease: asymptomatic Moyamoya registry (AMORE)","volume":"54","author":"Kuroda","year":"2023","journal-title":"Stroke"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"108277","DOI":"10.1016\/j.jstrokecerebrovasdis.2025.108277","article-title":"Predictors of perioperative stroke in patients with ischemic-type moyamoya disease treated with surgical revascularization: a retrospective multicenter study","volume":"34","author":"Musmar","year":"2025","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1007\/s00246-019-02071-w","article-title":"Modifiable clinical correlates of vascular health in children and adolescents with dyslipidemia","volume":"40","author":"White","year":"2019","journal-title":"Pediatr Cardiol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1186\/s12872-023-03496-1","article-title":"MiR-483-5p downregulation alleviates ox-LDL induced endothelial cell injury in atherosclerosis","volume":"23","author":"Zhu","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"20247053116 10.1155\/2024\/7053116","DOI":"10.1155\/2024\/7053116","article-title":"Overexpression of TRPV6 inhibits coronary atherosclerosis-related inflammatory response and cell apoptosis via the PKA\/UCP2 pathway","volume":"2024","author":"Zheng","year":"2024","journal-title":"Cardiovasc Ther"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"513","DOI":"10.3390\/ijms22073513","article-title":"Pathophysiology of atherosclerotic plaque development-contemporary experience and new directions in research","volume":"22","author":"Kowara","year":"2021","journal-title":"Int J Mol Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1502326","DOI":"10.3389\/fcvm.2024.1502326","article-title":"Cardioprotection in coronary artery bypass graft surgery: the impact of remote ischemic preconditioning on modulating LOX-1 and SOD-1 to counteract oxidative stress","volume":"11","author":"Luca","year":"2024","journal-title":"Front Cardiovasc Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1111\/joim.13580","article-title":"The red blood cell as a mediator of endothelial dysfunction in patients with familial hypercholesterolemia and dyslipidemia","volume":"293","author":"Mahdi","year":"2023","journal-title":"J Intern Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e036830","DOI":"10.1161\/jaha.124.036830","article-title":"RNF213 variant and infectious burden associated with intracranial artery stenosis in Moyamoya disease","volume":"14","author":"Zeng","year":"2025","journal-title":"J Am Heart Assoc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1177\/0271678x241245557","article-title":"RNF213 variant and autophagic impairment: a pivotal link to endothelial dysfunction in moyamoya disease","volume":"44","author":"Shin","year":"2024","journal-title":"J Cereb Blood Flow Metab"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"321","DOI":"10.5551\/jat.64795","article-title":"Assessment of low-density lipoprotein cholesterol levels and non-invasive vascular health in school-aged children: a study in Ogasa District, Shizuoka prefecture","volume":"32","author":"Hasegawa","year":"2025","journal-title":"J Atheroscler Thromb"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"430","DOI":"10.3390\/medicina58101430","article-title":"Perioperative management and clinical outcomes of liver transplantation for children with homozygous familial hypercholesterolemia","volume":"58","author":"Qiu","year":"2022","journal-title":"Medicina (Kaunas)"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.3171\/2015.5.Jns142973","article-title":"Association of apolipoprotein E gene polymorphism with small-vessel lesions and stroke type in moyamoya disease: a preliminary study","volume":"124","author":"Jang","year":"2016","journal-title":"J Neurosurg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"538","DOI":"10.3390\/nu17030538","article-title":"Metabolic syndrome in the Amazon: customizing diagnostic methods for urban communities","volume":"17","author":"Alcaide-Leyva","year":"2025","journal-title":"Nutrients"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"434 10.3389\/fcvm.2017.00034","DOI":"10.3389\/fcvm.2017.00034","article-title":"Low-density lipoprotein receptor-related Protein-1 signaling in angiogenesis","volume":"4","author":"Mao","year":"2017","journal-title":"Front Cardiovasc Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"466","DOI":"10.12998\/wjcc.v12.i3.466","article-title":"Is medical management useful in Moyamoya disease?","volume":"12","author":"Muengtaweepongsa","year":"2024","journal-title":"World J Clin Cases"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1602006\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T15:50:00Z","timestamp":1748965800000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1602006\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":29,"alternative-id":["10.3389\/fneur.2025.1602006"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1602006","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2025,5,22]]},"article-number":"1602006"}}