Cholesterol Levels Are Associated with 30-day Mortality from Ischemic Stroke in Dialysis Patients

Wang, I.-Kuan; Liu, Chung‐Hsiang; Yen, Tzung‐Hai; Jeng, Jiann‐Shing; Hsu, Shih‐Pin; Chen, Chih‐Hung; Lien, Li-Ming; Lin, Ruey‐Tay; Chen, An‐Chih; Lin, Hongbo; Chi, Hsin‐Yi; Lai, Ta‐Chang; Sun, Yu; Lee, Siu-Pak; Sung, Sheng-Feng; Chen, Po‐Lin; Lee, Jiunn‐Tay; Chiang, Tsuey-Ru; Lin, Shinn-Kuang; Muo, Chih‐Hsin; Ma, Henry; Wen, Chi‐Pang; Sung, Fung‐Chang; Hsu, Chung Y.; Tsai, Chon‐Haw; Huang, Wei-Shih; Lu, Chung-Ta; Tsai, Tzung-Chang; Tseng, Chun-Hung; Lin, Kang-Hsu; Shyn, Woei-Cherng; Yang, Yu‐Wan; Liu, Yen-Liang; Cho, Der Yang; Chen, Chun-Chung; Tang, Sung‐Chun; Tsai, Li‐Kai; Yeh, Shin-Joe; Chen, Han‐Jung; Chang, Cheng-Sen; Kuo, Hung-Chang; Lee, Lian-Hui; Tsui, Huan-Wen; Tsou, Jung-Chi; Wang, Yantang; Tai, Yi‐Cheng; Tsai, Kun-Chang; Chen, Yen‐Wen; Lu, Kan V.; Liliang, Po-Chao; Tsai, Yu-Tun; Liang, Cheng‐Loong; Wang, Kuo-Wei; Wang, Hao‐Kuang; Chen, Jui‐Sheng; Chen, Po‐Yuan; Chye, Cien-Leong; Tzeng, Wei-Jie; Wu, Peng; Sung, Pi‐Shan; Hsieh, Han-Chieh; Su, Hui‐Chen; Chiu, Hou‐Chang; Chen, Wei‐Hung; Bai, Chyi‐Huey; Huang, Tzu-Hsuan; Lau, Chi-Ieong; Wu, Ya-Ying; Yeh, Hsu-Ling; Chang, Anna Marie; Lin, Ching‐Huang; Yen, Cheng-Chang; Chen, Chun‐Hung; Khor, Gim-Thean; Chao, A-Ching; Lin, Hsiu-Fen; Huang, Poyin; Ke, Der-Shin; Chang, Chia‐Yu; Yeh, Poh‐Shiow; Lin, Kao‐Chang; Cheng, Tain‐Junn; Chou, Chih-Ho; Yang, Chun-Ming; Shen, Hsiu-Chu; Tsai, Shih-Jei; Lu, Tsong-Ming; Kung, Sheng-Ling; Lee, Mei-Ju; Chou, Hsi-Hsien; Pan, Chou-Hsiung; Chan, Po-Chi; Hsu, Min-Hsien; Chang, Wei‐Lun; Huang, Zhi-Zang; Shoung, Hai-Ming; Lo, Yi‐Chen; Wang, Fu-Hwa; Yin, Jiu‐Haw; Wang, Chung-Jen; Wang, Kai-Chen; Chen, Limei; Denq, Jong-Chyou; Lu, Chien-Jung; Lin, Cheng-Huai; Huang, Chieh‐Cheng; Liu, Chang-Hsiu; Chan, Hoi-Fong; Sun, Ming‐Hui; Ke, Li-Ying; Lee, Yu-Shan; Ong, Cheung-Ter; Wu, Chi-Shun; Hsu, Yung-Chu; Su, Yu-Hsiang; Hung, Ling-Chien; Lin, Jiann‐Chyun; Hsu, Yaw‐Don; Peng, Giia‐Sheun; Hsu, Chang-Hung; Lin, Chun‐Chieh; Yen, Che-Hung; Cheng, Chun-An; Sung, Yueh‐Feng; Chen, Yuanliang; Lien, Ming-Tung; Chou, Chung-Hsing; Liu, Chia-Chen; Yang, Fu-Chi; Wu, Yi-Chung; Tso, An-Chen; Lai, Yu-Hua; Chiang, Chun-I; Tsai, Chia-Kuang; Liu, Meng-Ta; Lin, Ying-Che; Hsu, Yu-Chuan; Lee, Mei‐Ching; Huang, Pai-Hao; Lie, Sian-King; Liao, Pin-Wen; Chen, Jen-Tse; Sun, Mu‐Chien; Lai, Tien-Pao; Chen, Wei‐Liang; Chen, Yen-Chun; Chen, Ta-Cheng; Wang, Wenfu; Lee, Kwo-Whei; Chang, Chen-Shu; Lai, Chien-Hsu; Shih, Siao-Ya; Chuang, Chieh-Sen; Chen, Yen‐Yu; Chen, Chien‐Min; Su, Yu-Chin; Hsiao, Cheng-Lun; Yang, Fu-Yi; Liu, Chih-Yang; Chiang, Han‐Lin; Chang, Chun-Yuan; Lin, Ichih; Chien, Chung-Hsien; Chang, Yang-Chuang; Chen, Ping-Kun; Chiu, Pai-Yi; Hsiao, Yu‐Jen; Fang, Chen-Wen; Chen, Yuwei; Lee, Kuo-Ying; Lin, Yun-Yu; Li, Chenhua; Tsai, Hui-Fen; Hsieh, Chuan-Fa; Yang, Chih-Dong; Liaw, Shiumn-Jen; Liao, How-Chin; Yeh, Shoou-Jeng; Wu, Lingli; Hsieh, Liang-Po; Lee, Yonghui; Chen, Chung-Wen; Hsu, Chih-Yuan; Jhih, Ye-Jian; Zhuang, Hao-Yu; Pan, Yan-Hong; Shih, Shin-An; Chen, Chin-I; Sung, Jia-Ying; Weng, Hsing-Yu; Teng, Hao-Wen; Lee, Jing-Er; Huang, Chih-Shan; Chao, Shu-Ping; Yuan, Rey-Yue; Sheu, Jau Jiuan; Yu, Jia‐Ming; Ho, Chun-Sum; Lin, Ting-Chun; Yu, Shih-Chieh; Chen, Jiunn-Rong; Tsai, Song-Yen; Wei, Cheng‐Yu; Yang, Chao-Nan; Hung, Chao-Hsien; Shih, Ian; Tseng, Hung-Pin; Liu, Chin-Hsiung; Lin, Chun‐Liang; Lin, Hung‐Chih; Chen, Pi-Tzu; Hu, Chaur‐Jong; Chi, Nai‐Fang; Chan, Lung; Chern, Chang‐Ming; Lin, Cheng-Hsien; Wang, Shuu Jiun; Hsu, Li-Chi; Wong, Wen-Jang; Lee, I‐Hui; Yen, Der‐Jen; Tsai, Ching-Piao; Kwan, Shang‐Yeong; Soong, Bing‐Wen; Chen, Shih‐Pin; Liao, Kwong‐Kum; Lin, K.P.; Chen, Chien; Shan, Din‐E; Fuh, Jong‐Ling; Wang, Pei‐Ning; Lee, Yi‐Chung; Yu, Yu-Hsiang; Huang, Hui‐Chi; Tsai, Jui-Yao; Wu, Ming-Hsiu; Chen, Shi-Cheng; Chiang, Szu-Yi; Wang, Chiung-Yao; Hsu, Ming-Chin; Chen, Chien‐Chung; Yeh, Po-Yen; Tsai, Yu-Tai; Wang, Ko-Yi; Chen, Tsang-Shan; Yip, Ping-Keung; Wang, Vinchi; Wang, Kaw-Chen; Tsai, Chung-Fen; Chen, Chao-Ching; Chen, Chih‐Hao; Liu, Yi‐Chien; Chen, Shao-Yuan; Zhao, Zihao; Wei, Zhipeng; Wu, Shey-Lin; Liu, Ching-Kuan; Lin, Ryh-Huei; Chu, Ching-Hua; Yan, Sui-Hing; Lin, Yi‐Chun; Chen, Pei‐Yun; Hsiao, Sheng-Huang; Yip, Bak-Sau; Tsai, Pei-Chun; Chou, Ping-Chen; Kuo, Tsam-Ming; Lee, Yi‐Chen; Chiu, Yi-Pin; Liao, Yue -Yuan; Tsai, Ming-Jun; Kao, Hsin-Yi

doi:10.1016/j.jstrokecerebrovasdis.2017.02.007

Cited by 7 publications

(7 citation statements)

References 27 publications

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“…CYP11A gene, a member of CYP genes, encodes a cholesterol side chain cleavage enzyme (cytochrome P450 cholesterol side-chain cleavage, P450scc) that plays a major role in the control of steroidogenesis, by mediating the conversion of cholesterol to pregnenolone [21]. Dyslipidemia such as low concentration of high-density lipoprotein cholesterol (HDL-C), high levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) was one of the most important risk factors of IS [22]. These lines of evidence have led us to formulate the hypothesis that CYP3A4 and CYP11A1 could be of pathogenic importance in IS.…”

Section: Discussionmentioning

confidence: 99%

CYP3A4 and CYP11A1 variants are risk factors for ischemic stroke: a case control study

et al. 2020

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Background: This study aimed to investigate the roles of CYP3A4 and CYP11A1 variants in ischemic stroke (IS) susceptibility among the Han Chinese population. Methods: Four hundred seventy-seven patients with IS and 493 healthy controls were enrolled. Seven singlenucleotide polymorphisms (SNPs) of CYP3A4 and CYP11A1 were genotyped by Agena MassARRAY. Odds ratio (OR) and 95% confidence intervals (CI) were calculated by logistic regression adjusted for age and gender. Results: We found that CYP3A4 rs3735451 (OR = 0.81, p = 0.039) and rs4646440 (OR = 0.72, p = 0.021) polymorphisms decreased the risk of IS. CYP3A4 rs4646440 (OR = 0.74, p = 0.038) and CYP11A1 rs12912592 (OR = 1.58, p = 0.034) polymorphisms were correlated with IS risk in males. CYP3A4 rs3735451 (OR = 0.63, p = 0.031) and rs4646440 (OR = 0.57, p = 0.012) possibly weaken the IS susceptibility at age > 61 years. Besides, CYP3A4 rs4646437 (OR = 0.59, p = 0.029), CYP11A1 rs12912592 (OR = 1.84, p = 0.017) and rs28681535 (OR = 0.66, p = 0.038) were associated with IS risk at age ≤ 61 years. CYP11A1 rs28681535 TT genotype was higher high-density lipoprotein cholesterol level than the GT and GG genotype (p = 0.027). Conclusions: Our findings indicated that rs3735451, rs4646440, rs4646437 in CYP3A4 and rs28681535 in CYP11A1 might be protective factors for IS, while CYP11A1 rs12912592 polymorphism be a risk factor for IS in Chinese Han population.

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Section: Discussionmentioning

confidence: 99%

CYP3A4 and CYP11A1 variants are risk factors for ischemic stroke: a case control study

et al. 2020

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show abstract

“…CYP11A gene, a member of CYP genes, encodes a cholesterol side chain cleavage enzyme (cytochrome P450 cholesterol side-chain cleavage, P450scc) that plays a major role in the control of steroidogenesis, by mediating the conversion of cholesterol to pregnenolone [19]. Dyslipidemia such as low concentration of high-density lipoprotein cholesterol (HDL-C), high levels of low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) was one of the most important risk factors of IS [20]. These lines of evidence have led us to formulate the hypothesis that CYP3A4 and CYP11A1 could be of pathogenic importance in IS.…”

Section: Discussionmentioning

confidence: 99%

CYP3A4 and CYP11A1 Variants are Risk Factors for Ischemic Stroke: a Case Control Study

Gao

Tang

Gao

et al. 2019

Preprint

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Background This study aimed to investigate the roles of CYP3A4 and CYP11A1 variants in ischemic stroke (IS) susceptibility among the Han Chinese population. Methods 477 patients with IS and 493 healthy controls were enrolled. Seven single-nucleotide polymorphisms (SNPs) of CYP3A4 and CYP11A1 were genotyped by Agena MassARRAY. Odds ratio (OR) and 95% confidence intervals (CI) were calculated by logistic regression adjusted for age and gender. Results We found that CYP3A4 rs3735451 (OR = 0.81, p = 0.039) and rs4646440 (OR = 0.72, p = 0.021) polymorphisms decreased the risk of IS. CYP3A4 rs4646440 (OR = 0.74, p = 0.038) and CYP11A1 rs12912592 (OR = 1.58, p = 0.034) polymorphisms were correlated with IS risk in males. CYP3A4 rs3735451 (OR = 0.63, p = 0.031) and rs4646440 (OR = 0.57, p = 0.012) possibly weaken the IS susceptibility at age > 61 years. Besides, CYP3A4 rs4646437 (OR = 0.59, p = 0.029), CYP11A1 rs12912592 (OR = 1.84, p = 0.017) and rs28681535 (OR = 0.66, p = 0.038) were associated with IS risk at age ≤ 61 years. Haplotype analysis showed that CYP3A4 GT haplotype (rs4646440 and rs35564277) increased the susceptibility to IS (OR = 1.29, p = 0.033). CYP11A1 rs28681535 TT genotype was higher high-density lipoprotein cholesterol level than the GT and GG genotype (p = 0.027). Conclusions Our findings indicated that rs3735451, rs4646440, rs4646437 in CYP3A4 and rs28681535 in CYP11A1 might be protective factors for IS, while CYP11A1 rs12912592 polymorphism be a risk factor for IS in Chinese Han population.

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“…The TSR enrolls patients who are presented within 10 days of symptom onset to a TSR hospital because of 1 of the 4 major stroke types (i.e., ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack). The TSR program was launched in 2006, and more than 100,000 stroke events had been recorded in the TSR up to 2018 [15][16][17]. Initially, 39 hospitals across the country participated in the registration project, and study protocols were approved by the Institutional Review Board of each participating hospital.…”

Section: Standard Protocol Approvals Registrations and Patient Consentsmentioning

confidence: 99%

The Misleading "Smoker's Paradox" in Young Stroke

Liang

Chen

Lee

et al. 2021

Preprint

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Objective: Stroke in young adults is uncommon, and the etiologies and risk factors of stroke in young adults differ from those in the older populations. Smoker’s paradox is an unexpected favorable outcome, and age difference was used to explain the association between smoking and the favorable functional outcome. This study aimed to investigate the existence of this phenomenon in young stroke patients.Methods: We analyzed a total of 9,460 young stroke cases registered in the nationwide stroke registry system of Taiwan between 2006 and 2016. Smoking criteria included having a past or current history of smoking more than 1 cigarette per day for more than 6 months. After matching for sex and age, a Cox model was used to compare complications, mortality and outcomes between smokers and non-smokers.Results: Smoking was associated with older age, higher comorbidities, and higher alcohol consumption. Smoking patients with NIHSS scores of 11–15 had a worse functional outcome (adjusted OR, 0.81; 95% CI, 0.76–0.87), and smoking cessation would substantially reverse those effects.Conclusion: The smoker’s paradox definitely does not exist, and therefore we continue to strongly advocate the importance of smoking cessation.

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Cholesterol Levels Are Associated with 30-day Mortality from Ischemic Stroke in Dialysis Patients

Cited by 7 publications

References 27 publications

CYP3A4 and CYP11A1 variants are risk factors for ischemic stroke: a case control study

CYP3A4 and CYP11A1 variants are risk factors for ischemic stroke: a case control study

CYP3A4 and CYP11A1 Variants are Risk Factors for Ischemic Stroke: a Case Control Study

The Misleading "Smoker's Paradox" in Young Stroke

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