Comprehensive plasma lipidomic profiles reveal a lipid-based signature panel as a diagnostic and predictive biomarker for cerebral aneurysms

We investigated lipidomic features from healthy controls (HCs), patients with unruptured cerebral aneurysms (UCAs) and ruptured CAs (RCAs) to analyze their lipidomic profiles and identify a lipid signature associated with CAs. Patients (n = 540) were enrolled from two centers. We identified significantly altered plasma lipids in 2 cohort with the total lipid intensity decreasing from HC to UCA to RCA. Triglycerides comprised the distinct profile of lipids in CAs. A four-lipid signatures showed good calibration and diagnostic prediction for CA vs. HC and UCA vs. RCA, but independent discriminate CA from HC, UCA from RCA, and RCA (RI and RII) or UCA (UI and UII) subtypes, in training and validation cohorts. Comprehensive lipidomic profiles identified decreased lipids as a prominent feature of CA development, and a four-lipid signature could not only better diagnose and predict UCAs/RCAs from HCs, but also predicted patients subtypes with severe RCA or high-risk UCA.