Objective: This study aimed to investigate the association between high-mobility-group box 1 (
HMGB1) and
stroke-associated
pneumonia (SAP) in
acute ischemic stroke (AIS) patients. Methods: AIS patients were enrolled in two centers. The serum samples were collected within the first 24 h after admission, and
HMGB1 levels were measured by
enzyme-linked
immunosorbent assay. Logistic regression models were used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of SAP for
HMGB1 concentrations. Restricted cubic splines (RCS) were performed to explore the shapes of the association between
HMGB1 concentrations and SAP. Results: From January 2022 to May 2022, a total of 420 AIS patients were enrolled. Ninety-six (22.9%) patients develop SAP. The levels of
HMGB1 in the SAP group were higher than those in the non-SAP group (p < 0.001). Using the first quartile of
HMGB1 group as a reference, patients in the fourth quartile of
HMGB1 group had the highest likelihood of experiencing SAP in the unadjusted model (OR = 3.687; 95% CI: 1.851−7.344), age- and sex-adjusted model (OR = 3.511; 95% CI: 1.725−7.147), and multivariable-adjusted model (OR = 2.701; 95% CI: 1.045−6.981).
HMGB1 was also independently associated with SAP as a continuous variable in the unadjusted model (OR = 1.132; 95% CI: 1.069−1.199), age- and sex-adjusted model (OR = 1.131; 95% CI: 1.066−1.200), and multivariable-adjusted model (OR = 1.096; 95% CI: 1.011−1.188). RCS showed a linear association between
HMGB1 and SAP (p for linear trend = 0.008) Conclusions:
HMGB1 might be able to act as a potential
biomarker of SAP in AIS patients.