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Shen Y, Wang J, Wang A, Zhao X. Association Between Low-Density Lipoprotein-Cholesterol Level and Risk of Intracranial Atherosclerotic Stenosis: Results From the APAC Study. Neurologist 2023; 28:300-303. [PMID: 37083844 PMCID: PMC10521774 DOI: 10.1097/nrl.0000000000000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
BACKGROUND It is unknown whether plasma low-density lipoprotein-cholesterol level (LDL-C) can predict the occurrence of intracranial atherosclerotic stenosis (ICAS), especially asymptomatic (A)ICAS. This study investigated whether LDL-C level is independently associated with AICAS. METHODS The Asymptomatic Polyvascular Abnormalities Community study is an ongoing community-based, prospective, long-term follow-up observational study with 3387 participants. AICAS was diagnosed by transcranial Doppler ultrasonography. The participants were divided into 3 groups based on LDL-C level. Cox regression was used to evaluate the association between LDL-C level and incidence of AICAS. RESULTS During 2 years of follow-up, 9.98% of participants were diagnosed with AICAS. The incidence of AICAS (person-years with 95% CI) was 4.99% (4.48%-5.50%). AICAS incidence did not increase with increasing LDL-C level. Compared with the <2.6 mmol/l subgroup, the incidence of asymptomatic ICAS was not significantly higher in the 2.6 to 3.4 and >3.4 mmol/l subgroups after adjusting for confounding factors (hazard ratio=0.95, 95% CI: 0.86-1.03 and hazard ratio=0.96, 95% CI: 0.84-1.10, respectively). CONCLUSIONS LDL-C is not an independent predictor of AICAS incidence in the Chinese population.
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Affiliation(s)
- Yuan Shen
- Department of Neurology, Beijing Tiantan Hospital
- China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders
- Center of Stroke, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease
| | - Jing Wang
- Department of Neurology, Beijing Tiantan Hospital
- China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders
- Center of Stroke, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital
- China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders
- Center of Stroke, Beijing Institute for Brain Disorders
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease
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Jiao Y, Tian T, Wei S, Wang C, Wu L. Association between serum non-high-density lipoprotein cholesterol and cognitive dysfunction after acute ischemic stroke: a cross-sectional study. Braz J Med Biol Res 2021; 53:e9487. [PMID: 33146286 PMCID: PMC7643927 DOI: 10.1590/1414-431x20209487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 08/19/2020] [Indexed: 12/05/2022] Open
Abstract
This study aimed to explore the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) and cognitive dysfunction risk in patients with acute ischemic stroke (AIS). This cross-sectional study enrolled 583 AIS patients. Biochemical markers and lipid profile were collected after admission. AIS patients were classified into high group (non-HDL-C ≥3.4 mM) and normal group (non-HDL-C <3.4 mM). Mini-Mental State Examination scale (MMSE), Montreal Cognitive Assessment scale (MoCA), Activities of Daily Living (ADL) scale, Neuropsychiatric Inventory (NPI), and Hamilton Depression scale 21 version (HAMD-21) were applied on the third day after admission. Compared with the control group, patients of the high group had higher body mass index and higher frequency of intracranial artery stenosis, and exhibited higher levels of non-HDL-C, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homocysteine, fasting blood glucose, and glycosylated hemoglobin (HbA1c), and lower levels of high-density lipoprotein cholesterol (all P<0.05). Compared with the control group, patients of the high group had significantly lower MMSE and MoCA scores (MMSE: 26.01±4.17 vs 23.12±4.73, P<0.001; MoCA: 22.28±5.28 vs 20.25±5.87, P<0.001) and higher scores on the NPI and HAMD-21 (both P<0.001). MMSE (r=-0.306, P<0.001) and MoCA scores (r=-0.251, P<0.001) were negatively associated with non-HDL-C level. Multivariate regression analysis revealed that non-HDL-C level (OR=1.361, 95%CI: 1.059-1.729, P=0.016) was independently associated with the presence of cognitive dysfunction after adjusting for confounding factors. High serum non-HDL-C level might significantly increase the risk of cognitive dysfunction after AIS.
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Affiliation(s)
- Yinghui Jiao
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China
| | - Tian Tian
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China
| | - Shasha Wei
- Operating Room, Weifang Brain Hospital, Weifang, Shandong, China
| | - Chengdong Wang
- Prenatal Diagnosis Laboratory, Weifang People's Hospital, Weifang, Shandong, China
| | - Lili Wu
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong, China
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3
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Kang K, Wang Y, Wu J, Wang A, Zhang J, Xu J, Ju Y, Zhao X. Association Between Cumulative Exposure to Increased Low-Density Lipoprotein Cholesterol and the Prevalence of Asymptomatic Intracranial Atherosclerotic Stenosis. Front Neurol 2020; 11:555274. [PMID: 33324314 PMCID: PMC7726214 DOI: 10.3389/fneur.2020.555274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/05/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose: Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical or subclinical ischemic events, while the relationship between low-density lipoprotein cholesterol (LDL-C) measured at a single time point and intracranial atherosclerotic stenosis (ICAS) is inconsistent. This study aims to assess the association between cumulative exposure to increased LDL-C and the prevalence of asymptomatic ICAS. Methods: The Asymptomatic Polyvascular Abnormalities Community study was investigated on the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. In this study, we included 4,523 participants with LDL-C measured at 3 examinations in 2006, 2008, and 2010. Cumulative exposure to increased LDL-C was calculated as following: LDL-C burden2006−2008 = [(LDL-C2006-1.8) + (LDL-C2008-1.8)]/2 * time2006−2008; LDL-C burden = LDL-C burden2006−2008 + LDL-C burden2008−2010. Transcranial doppler ultrasonography was performed in 2010 to detecting the ICAS. Results: Of the 4,347 patients, 13.3% (580/4,347) were diagnosed with ICAS. In univariate analysis, the association between LDL-C burden and ICAS prevalence was significant, the odds ratios (95% confidence interval) from the lowest to the highest quartile were 1 (reference), 1.30 (0.99–1.70), 1.32 (1.01–1.73), and 2.14 (1.66–2.75), respectively (P < 0.05). After adjustment for potential confounding factors, the same result was reached. Conclusions: Cumulative exposure to increased LDL-C is concentration-dependently associated with increased prevalence of asymptomatic ICAS, especially in those under the age of 65 y or free of hypertension, diabetes mellitus, and hyperlipidemia.
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Affiliation(s)
- Kaijiang Kang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yu Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jianwei Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jie Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yi Ju
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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4
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Woo NE, Na HK, Heo JH, Nam HS, Choi JK, Ahn SS, Choi HS, Lee SK, Lee HS, Cha J, Kim YD. Factors for Enhancement of Intracranial Atherosclerosis in High Resolution Vessel Wall MRI in Ischemic Stroke Patients. Front Neurol 2020; 11:580. [PMID: 32676051 PMCID: PMC7333774 DOI: 10.3389/fneur.2020.00580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: High resolution vessel wall MRI (VW-MRI) has enabled to characterize intracranial atherosclerosis (ICAS). We studied to identify the factors for enhancement of ICAS in VW-MRI in patients with acute ischemic stroke. Methods: Consecutive patients with acute ischemic stroke or TIA who underwent VW-MRI between January 2017 and December 2017 were included. Enhancement on VW-MRI was defined as an increase in intensity on contrast-enhanced T1-weighted sequence. We compared the clinical and the radiologic findings between patients with wall enhancement and those without wall enhancement. Results: Of the 48 patients with ICAS, 28 patients revealed enhancement on VW-MRI. Patients with enhancement were more likely to have severe stenotic lesions and higher levels of total cholesterol, triglycerides, low-density cholesterol, Apo (b), and Apo (b)/Apo (a) lipoprotein ratio (p < 0.05). Multivariable analysis demonstrated that total cholesterol (OR: 5.378, 95% CI, 1.779-16.263), triglycerides (OR: 3.362, 95% CI, 1.008-11.209), low density lipoprotein cholesterol (OR: 4.226, 95% CI, 1.264-14.126), Apo (b) lipoprotein (OR: 3639.641, 95% CI, 17.854-741954.943) levels, and Apo (b)/Apo (a) lipoprotein ratio (OR, 65.514; 95% CI, 1.131-3680.239) were independently associated with enhancement of ICAS. High-density lipoprotein cholesterol and Apo (a) lipoprotein levels were not significantly different between the patients with wall enhancement and those without wall enhancement. Conclusions: The presence and severity of enhancement of ICAS was significantly associated with dyslipidemic conditions. These results suggest that strict lipid modification should be achieved for the management of ICAS.
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Affiliation(s)
- Na-Eun Woo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Han Kyu Na
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji Hoe Heo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Kyo Choi
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Soo Ahn
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Seok Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Jihoon Cha
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Dae Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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5
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Yang WS, Li R, Shen YQ, Wang XC, Liu QJ, Wang HY, Li Q, Yao GE, Xie P. Importance of lipid ratios for predicting intracranial atherosclerotic stenosis. Lipids Health Dis 2020; 19:160. [PMID: 32622367 PMCID: PMC7335436 DOI: 10.1186/s12944-020-01336-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population. METHODS This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated. RESULTS The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P < 0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analysis revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS. CONCLUSION The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients.
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Affiliation(s)
- Wen-Song Yang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Rui Li
- Division of Life Sciences and Medicine, Department of Neurology, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, 230001, P.R. China
| | - Yi-Qing Shen
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xing-Chen Wang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Department of Psychiatry, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan, China
| | - Qing-Jun Liu
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160, China
| | - Hai-Yang Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Qi Li
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. .,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Guo-En Yao
- Department of Neurology, First Affiliated Hospital, PLA General Hospital, Beijing, 100048, China.
| | - Peng Xie
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China. .,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Wu J, Wang Y, Wang A, Jia J, Wang X, Zhao X. Association between non‐high‐density lipoprotein cholesterol levels and the prevalence of asymptomatic extracranial internal carotid artery stenosis in a Chinese community‐based study. Eur J Neurol 2019; 26:740-746. [DOI: 10.1111/ene.13882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J. Wu
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- China National Clinical Research Center for Neurological Diseases BeijingChina
- Center of Stroke Beijing Institute for Brain Disorders BeijingChina
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina
| | - Y. Wang
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- China National Clinical Research Center for Neurological Diseases BeijingChina
- Center of Stroke Beijing Institute for Brain Disorders BeijingChina
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina
| | - A. Wang
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- Department of Epidemiology and Health Statistics School of Public Health Capital Medical University BeijingChina
- Beijing Municipal Key Laboratory of Clinical Epidemiology Beijing China
| | - J. Jia
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- China National Clinical Research Center for Neurological Diseases BeijingChina
- Center of Stroke Beijing Institute for Brain Disorders BeijingChina
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina
| | - X. Wang
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- China National Clinical Research Center for Neurological Diseases BeijingChina
- Center of Stroke Beijing Institute for Brain Disorders BeijingChina
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina
| | - X. Zhao
- Department of Neurology Beijing Tiantan Hospital Capital Medical University BeijingChina
- China National Clinical Research Center for Neurological Diseases BeijingChina
- Center of Stroke Beijing Institute for Brain Disorders BeijingChina
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease BeijingChina
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7
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Association between fasting Triglyceride levels and the Prevalence of Asymptomatic Intracranial Arterial Stenosis in a Chinese Community-based Study. Sci Rep 2018; 8:5744. [PMID: 29636518 PMCID: PMC5893624 DOI: 10.1038/s41598-018-24157-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/28/2018] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to assess the association between fasting triglyceride (FTG) levels and the prevalence of asymptomatic intracranial arterial stenosis (ICAS). The Asymptomatic Polyvascular Abnormalities Community (APAC) study is a sub-population of the Kailuan study which targeting on the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. A total number of 5345 participants, aged ≥40, and without history of stroke, transient ischemic attack, and coronary heart disease were enrolled in this study. Transcranial Doppler Ultrasonography was performed for the detection of ICAS presence. Out of 5345 participants, 698 subjects diagnosed ICAS (13.1%). In univariate analysis, the association between fasting TG (FTG) levels and asymptomatic ICAS didn’t reach statistical significance (OR: 0.99, 95% CI: 0.89–1.09; P = 0.79), the same conclusion was reached in multivariate analysis, after adjustment for age, sex (OR: 1.05, 95% CI: 0.95–1.17) and age, sex, current smoking status, hypertension, diabetes, body mass index, estimated glomerular filtration rate, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (OR: 0.95, 95% CI: 0.84–1.06), respectively. FTG failed to show any statistical significance on ICAS presence in the APAC study, but the TG actually plays an important role in the progression of atherosclerosis as a biomarker.
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Ahn JK, Hwang J, Hwang JH, Yoon WT, Chung PW, Ryu S. The association between serum uric acid and asymptomatic intracranial arterial stenosis in middle-aged Koreans. Nutr Metab Cardiovasc Dis 2018; 28:14-22. [PMID: 29191476 DOI: 10.1016/j.numecd.2017.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/07/2017] [Accepted: 10/17/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, especially in Asians. Hyperuricemia has been associated with an increased risk of comorbidities such as metabolic syndrome or cardiovascular diseases. However, there are few studies focusing on the association between serum uric acid (SUA) levels and asymptomatic ICAS. The aim of this study was to explore the association between SUA and the prevalence of ICAS in middle-aged Korean health screening examinees. METHODS AND RESULTS A cross-sectional study was performed on 9417 males and 7755 females who underwent a comprehensive health examination including transcranial Doppler (TCD) ultrasonography. The association of SUA and ICAS was analyzed using multivariate logistic regression. The prevalence of ICAS among the total examinee population was 3.55%. In females, the multivariate-adjusted odds ratio for ICAS was 1.52 (confidence interval 1.13-2.04) in the 3rd quartile of SUA and 1.45 (1.05-2.00) in the highest quartile, compared to the reference (P for trend 0.008). This trend was evident in all clinically relevant subgroups evaluated, including women with low inflammation status. SUA was not significantly associated with the prevalence of ICAS among males. In a sensitivity analysis, the multivariate-adjusted odds ratio of middle cerebral artery stenosis in females was 1.60 (1.09-2.37) in the highest quartile compared to the reference (P for trend 0.023). CONCLUSIONS Higher SUA level was associated with increased risk of ICAS among middle-aged females but not males. A further cohort study is warranted to elucidate the effect of SUA on asymptomatic ICAS.
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Affiliation(s)
- J K Ahn
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - J Hwang
- Department of Internal Medicine, National Police Hospital, Seoul, South Korea
| | - J H Hwang
- Center for Health Promotion, Samsung Medical Center, Seoul, South Korea
| | - W T Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - P W Chung
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - S Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
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9
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Association between High-density-lipoprotein-cholesterol Levels and the Prevalence of Asymptomatic Intracranial Arterial Stenosis. Sci Rep 2017; 7:573. [PMID: 28373708 PMCID: PMC5428728 DOI: 10.1038/s41598-017-00596-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/07/2017] [Indexed: 01/09/2023] Open
Abstract
Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke, and a low level of high-density lipoprotein cholesterol (HDL-C) is also considered to be a predictor for stroke. However, the association between the HDL-C level and asymptomatic ICAS is uncertain. From 2010 to 2011, a random sample of 5,351 participants were enrolled in the Asymptomatic Polyvascular Abnormalities Community (APAC) study. The recruited participants were then separated into 5 roughly uniform-sized factions with varying HDL-C levels. Multivariate logistic regression was implemented to assess the connection of the HDL-C levels and the prevalence of asymptomatic ICAS. The prevalence of asymptomatic ICAS showed no gradual decrease with the increase of HDL-C levels. After adjustment for conventional risk factors, HDL-C levels still showed no significant association with asymptomatic ICAS. The odds ratios (OR) of the prevalence of asymptomatic ICAS between the first group and the other 4 groups were 0.98, 1.00, 0.92, and 0.87 with 95% confidence intervals (CI) being 0.76–1.27, 0.78–1.29, 0.71–1.19, and 0.66–1.13, respectively. The study showed little correlation between HDL-C levels and asymptomatic ICAS. Normal levels of HDL-C are not an independent risk factor for asymptomatic ICAS.
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10
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Wu J, Wang A, Li X, Wu S, Zhao X. Non-High-Density Lipoprotein Cholesterol Levels on the Risk of Asymptomatic Intracranial Arterial Stenosis: A Result from the APAC Study. Sci Rep 2016; 6:37410. [PMID: 27857223 PMCID: PMC5114648 DOI: 10.1038/srep37410] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/28/2016] [Indexed: 11/24/2022] Open
Abstract
Intracranial arterial stenosis (ICAS) is an important cause of ischemic stroke and transient ischemic attack (TIA), and the correlation between the plasma non-high density cholesterol (non-HDLC) levels and ICAS, especially asymptomatic ICAS (AICAS) is not clear. The Asymptomatic Polyvascular Abnormalities Community(APAC) study is a community-based, prospective, long-term follow-up observational study. 3387 participants were enrolled in this study. The diagnosis of AICAS was made by transcranial Doppler ultrasonography. The participants were then divided into 3 groups based on their non-HDLC levels. The cox regression was used to analyze the correlation between the non-HDLC level and the incidence of AICAS.9.98% of the participants were diagnosed with AICAS during 2 years following up. Multivariate analysis showed that non-HDL-C is an independent indicator for the incidence of AICAS (HR = 1.22, 95%CI: 1.06–1.40), The incidence of AICAS gradually increase with the increasing non-HDLC level. Compared with subgroup(non-HDLC < 3.4 mmol/l), incidence of AICAS was significantly higher in the subgroups(non-HDLC 3.4–4.1 mmol/l and non-HDLC ≥ 4.1 mmol/l) after adjustment for the confounding factors (HR = 1.32, 95%CI:1.02–1.73; HR = 1.46, 95%CI: 1.10–1.94, respectively). In conclusions, our findings suggest that elevated non-HDLC levels a significant risk factor for the development of AICAS in the APAC study.
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Affiliation(s)
- Jianwei Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xin Li
- Department of interventional neurology, The affiliated hospital of Qingdao university, Qingdao, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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Liu J, Huang Y, Chen G, Liu X, Wang Z, Cao Y, Li H, Song L, Li C, Zhao H, Chen S, Wang Y, Zhang R, Wang A, Wu S. Cumulative systolic blood pressure exposure in relation to cognitive function in middle-aged and elderly adults: A prospective, population-based study. Medicine (Baltimore) 2016; 95:e5514. [PMID: 27902618 PMCID: PMC5134811 DOI: 10.1097/md.0000000000005514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The association between systolic blood pressure (SBP) and cognitive function is controversial in elderly adults. In addition, few studies focused on the cumulative effect of SBP. We aimed to investigate the association between cumulative SBP exposure and cognitive function among middle-aged and elderly adults.The analysis was based on the Asymptomatic Polyvascular Abnormalities Community (APAC) study. The primary predictor was the cumulative SBP calculated by consecutive SBP values measured through baseline (2006-2007) up to the fourth examination (2012-2013). The cognitive function was estimated by mini-mental state examination (MMSE) in the fourth examination. Linear regression and logistic regression analyses were used to investigate the association between cumulative SBP and cognitive function.Among 2211 participants (41.4% female, aged 40-94 years), 167 (7.55%) were diagnosed with cognitive impairment (MMSE score < 24). Higher cumulative exposure to SBP (per SD increment) was independently associated with poor cognitive performance after controlling for multiple factors (P < 0.001). We observed nondifferential association between men and women. However, higher cumulative SBP in the adults aged ≥60 years had a stronger association with poor cognitive performance compared with that in adults aged 40 to 60 years.Greater exposure to cumulative SBP is associated with worse cognitive performance among middle-aged and elderly adults. This association is similar between men and women, but stronger in elderly adults.
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Affiliation(s)
- Jie Liu
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Yuling Huang
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Guojuan Chen
- Department of Neurology, Tangshan Gongren Hospital
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital
| | - Zhijun Wang
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Yibin Cao
- Department of Neurology, Tangshan Gongren Hospital
| | - Haitao Li
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | | | | | | | | | - Yiming Wang
- Department of Hepatobiliary Surgery, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | | | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Higher Levels of Lipoprotein Associated Phospholipase A2 is associated with Increased Prevalence of Cognitive Impairment: the APAC Study. Sci Rep 2016; 6:33073. [PMID: 27609335 PMCID: PMC5017024 DOI: 10.1038/srep33073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/19/2016] [Indexed: 12/16/2022] Open
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a unique circulating phospholipase with inflammatory and oxidative activities and the limited data regarding the relationship between Lp-PLA2 and cognitive impairment are conflicted. We conducted a cross-sectional study including 1,374 Chinese adults recruited from 2010 to 2011, aiming to evaluate the relationship between Lp-PLA2 levels and the prevalence of cognitive impairment in a Chinese community-based population. Participants underwent standardized evaluation. Serum Lp-PLA2 mass was measured by ELISA. Cognition status was evaluated via the Mini-Mental Status Exam (MMSE) and cognitive impairment was identified as MMSE <24. Multivariable logistic regression models were used to assess the associations of Lp-PLA2 mass with cognitive impairment. Lp-PLA2 mass was significantly associated with the prevalence of cognitive impairment after adjusting for other potential confounding factors (compared with the first quartile, adjusted ORs of the second, third, and fourth quartile were 2.058 (95% CI, 0.876–4.835), 2.834 (95% CI, 1.255–6.398), and 4.882 (95% CI, 2.212–10.777), p < 0.0001). In conclusion, elevated level of Lp-PLA2 mass was independently associated with the prevalence of cognitive impairment in Chinese adults.
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Lu D, Li P, Zhou Y, Xu X, Zhang H, Liu L, Tian Z. Association between serum non-high-density lipoprotein cholesterol and cognitive impairment in patients with acute ischemic stroke. BMC Neurol 2016; 16:154. [PMID: 27561255 PMCID: PMC5000447 DOI: 10.1186/s12883-016-0668-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/10/2016] [Indexed: 12/30/2022] Open
Abstract
Background Non-high density lipoprotein cholesterol (HDL-C) could be a good predictor of vascular disease outcomes. To evaluate the association between serum non-HDL-C and cognitive impairment in patients with acute ischemic stroke. Methods A total of 725 hospitalized patients with acute ischemic stroke were enrolled. They received conventional treatment. Cognitive function was assessed on the 3rd day after admission using mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Activity of Daily Living Scale (ADL), and Neuropsychiatric Inventory (NPI, and Hamilton depression rating scale 21-item (HAMD-21). Lipid profile and biochemical markers were measured, and non-HDL-C was calculated. Results Compared with patients with normal non-HDL-C, those with high non-HDL-C showed lower MMSE (23.1 ± 4.9 vs. 26.0 ± 4.6, P < 0.001) and MoCA (20.4 ± 6.4 vs. 22.2 ± 5.3 P = 0.01) scores, higher NPI (6.2 ± 1.2 vs. 3.3 ± 1.5, P < 0.001) and HADM-21 (6.0 ± 2.2 vs. 4.5 ± 1.9, P < 0.001) scores, and higher homocysteine (16.0 ± 3.8 vs. 14.3 ± 2.0 mmol/L, P = 0.044), fasting blood glucose (6.4 ± 2.7 vs. 6.1 ± 2.1 mmol/L, P = 0.041), and HbA1c (6.80 ± 1.32 % vs. 6.52 ± 1.17 %, P = 0.013) levels. MMSE (r = -0.526, P < 0.001), MoCA (r = −0.216, P < 0.001), and NPI (r = 0.403, P < 0.001) scores were correlated with non-HDL-C levels. High non-HDL-C levels were an independent risk factor for cognitive disorders after acute ischemic stroke (P = 0.034, odds ratio = 3.115, 95 % confidence interval: 1.088–8.917). Conclusions High serum non-HDL-C levels, age, education, homocysteine levels, and HAMD score were independent risk factors of cognitive impairment in patients with acute ischemic stroke. The risk of cognitive disorders after acute ischemic stroke increased with increasing non-HDL-C levels. This parameter is easy to assess in the clinical setting.
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Affiliation(s)
- Da Lu
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Pan Li
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Yuying Zhou
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China.
| | - Xiaolin Xu
- Department of Neurology, Second wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Huihong Zhang
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Liping Liu
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
| | - Zhiyan Tian
- Department of Neurology, Sixteenth wards, Tianjin Huanhu Hospital, Tianjin, 300060, China
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Li Q, Zhou Y, Dong K, Wang A, Yang X, Zhang C, Zhu Y, Wu S, Zhao X. The Association between Serum Uric Acid Levels and the Prevalence of Vulnerable Atherosclerotic Carotid Plaque: A Cross-sectional Study. Sci Rep 2015; 5:10003. [PMID: 25961501 PMCID: PMC4426733 DOI: 10.1038/srep10003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/26/2015] [Indexed: 12/16/2022] Open
Abstract
Little is known about the associations between serum uric acid (SUA) levels and atherosclerotic carotid plaque vulnerability. The aim of this study was to assess the associations of SUA levels with the prevalence of vulnerable atherosclerotic carotid plaque in a community-based cohort. In the Asymptomatic Polyvascular Abnormalities Community (APAC) study, cross-sectional data from 2860 Chinese residents who underwent SUA measurement and ultrasonographic assessment of carotid plaque were analyzed. Multivariable logistic regression models were used to assess the associations of SUA levels with presence of vulnerable carotid plaque. After adjustment for potential confounders, SUA levels were significantly associated with the prevalence of vulnerable plaque amongst the middle-aged adults (odds ratio [OR] = 1.19, 95% confidence interval [CI]: 1.11-1.28). Compared to the lowest quartile, quartiles 2, 3 and 4 had a prevalence OR of 1.33 (1.02-1.74), 1.70 (1.27-2.27) and 2.05 (1.53-2.75), respectively, for the presence of vulnerable carotid plaque (p for trend across quartiles < 0.001). In the APAC study, elevated SUA levels were independently associated with the prevalence of vulnerable carotid plaque in middle-aged adults.
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Affiliation(s)
- Qing Li
- 1] Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China [2] Department of Neurology, People's Hospital of Xinjiang Vygur Autonomous Region, Urumqi 830002, China
| | - Yong Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Kehui Dong
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Xin Yang
- Department of General Practice, School of General Practice and Continuing Education, Capital Medical University, Beijing 100069, China
| | - Caifeng Zhang
- Department of Neurology, Hebei United University Affiliated Hospital, Tangshan 063000, China
| | - Yi Zhu
- Department of Neurology, People's Hospital of Xinjiang Vygur Autonomous Region, Urumqi 830002, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan 063000, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
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Association between self-reported global sleep status and prevalence of hypertension in Chinese adults: data from the Kailuan community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:488-503. [PMID: 25575370 PMCID: PMC4306875 DOI: 10.3390/ijerph120100488] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 12/24/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Assessment of sleep only by sleep duration is not sufficient. This cross-sectional study aimed to investigate the potential association of self-reported global sleep status, which contained both qualitative and quantitative aspects, with hypertension prevalence in Chinese adults. METHODS A total of 5461 subjects (4076 of them were male) were enrolled in the current study and were divided into two groups with the age of 45 years as the cut-off value. Sleep status of all subjects was assessed using the standard Pittsburgh Sleep Quality Index (PSQI). Hypertension was defined as blood pressure ≥140/90 mmHg in the current study. RESULTS After adjusting for basic cardiovascular characteristics, the results of multivariate logistic regression indicated that sleep status, which was defined as the additive measurement of sleep duration and sleep quality, was associated with hypertension prevalence in males of both age groups (odds ratio (OR) = 1.11, 95% confidence interval (CI), 1.07-1.15, p < 0.05; OR = 1.12, 95% CI, 1.08-1.15, p < 0.05) and in females aged ≤45years (OR = 1.10, 95% CI, 1.02-1.18, p < 0.05). As one component of PSQI, short sleep duration was associated with hypertension prevalence only in Chinese male subjects, but this association disappeared after the further adjustment of the other components of PSQI that measured the qualitative aspect of sleep. CONCLUSION Association between sleep status and hypertension prevalence in Chinese adults varied by age and sex. Sleep should be measured qualitatively and quantitatively when investigating its association with hypertension.
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Elevated plasma total cholesterol level is associated with the risk of asymptomatic intracranial arterial stenosis. PLoS One 2014; 9:e101232. [PMID: 24992466 PMCID: PMC4081648 DOI: 10.1371/journal.pone.0101232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/04/2014] [Indexed: 11/30/2022] Open
Abstract
Background Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, and dyslipidemia was one of the most common risk factors related to ICAS. However, the correlation between the plasma total cholesterol level (PTC) and ICAS, especially asymptomatic ICAS (AICAS) is not clear. Materials and Methods 5,300 participants were enrolled in this study. The diagnosis of AICAS was made by transcranial Doppler ultrasonography. The participants were then divided into 5 essentially equal-sized groups based on their PTC levels. The multivariate logistic regression was used to analyze the correlation between the PTC level and the prevalence of AICAS. Results 13.0% of the participants were diagnosed with AICAS. The prevalence of AICAS gradually increased with the increasing PTC level. After adjusted by the possible confounding factors, the Odds Ratios (OR) of the AICAS prevalence between the 1st quintile group and the other 4 groups were 1.13, 1.23, 1.63 and 1.75 with 95% confident intervals (CI) of 0.84–1.52, 0.91–1.66, 1.20–2.22 and 1.23–2.47, respectively. The further subgroup analysis revealed that the PTC level was stronger for males (OR 1.42 95%CI 1.23–1.64), regarding the prevalence of AICAS. Conclusions In this large community-based study, the prevalence of AICAS is 13.0%, subjects with higher PTC levels showed a mild increase in the prevalence of AICAS. The PTC level is an independent risk factor of AICAS. Males seem to be significantly more vulnerable to the risk of AICAS.
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