LDL Subclasses in Ischemic Stroke: A Risk Factor?

et al. 2020

BMC Neurol

Background Acute ischemic stroke (AIS) is one of the leading causes of mortality and long-term disability worldwide. Our study aims to clarify the role of low-density lipoproteins (LDL) subclasses in the occurrence of AIS and develop a risk xprediction model based on these characteristics to identify high-risk people. Methods Five hundred and sixty-six patients with AIS and 197 non-AIS controls were included in this study. Serum lipids and other baseline characteristics including fasting blood glucose (GLU), serum creatinine (Scr), and blood pressure were investigated in relation to occurrence of AIS. The LDL subfractions were classified and measured with the Lipoprint System by a polyacrylamide gel electrophoresis technique. Results Levels of LDL-3, LDL-4 and LDL-5 subclasses were significantly higher in the AIS group compared to the non-AIS group and lower level of LDL-1 was prevalent in the AIS patients. Consistently, Spearman correlation coefficient demonstrated that sd-demonevels, especially LDL-3 and LDL-4 levels, were significantly positively correlated with AIS. Furthermore, there is a significant positive correlation between small dense LDL (sd-LDL, that is LDL-3 to 7) levels and serum lipids including total cholesterol (TC), Low density lipoprotein cholesterol (LDL-C), and Triglyceride (TG). Increased LDL-3 and LDL-4 as well as decreased LDL-1 and LDL-2 were correlated to the occurrence of AIS, even in the people with normal LDL-C levels. A new prediction model including 12 variables can accurately predict the AIS risk in Chinese patients (AUC = 0.82 ± 0.04). Conclusions Levels of LDL subclasses should be considered in addition to serum LDL-C in assessment and management of AIS. A new prediction model based on clinical variables including LDL subtractions can help clinicians identify high of AIS, even in the people with norm.

Section: Discussionmentioning

confidence: 97%

Estimation of the LDL subclasses in ischemic stroke as a risk factor in a Chinese population

Duan

et al. 2020

BMC Neurol

“…Limited studies exploring the relationship between LDL subclasses and AIS subtypes have been done. The atherogenic effect of sdLDL particles on carotid atherosclerosis is well known 35) . Higher levels of sdLDL-C and LDL-C were found in LAA, SAO, marker to predict ischemic stroke risk.…”

Section: Logistic Regression Models For Predicting the Risk And Prognmentioning

confidence: 99%

Association of Small Dense Low-Density Lipoprotein Cholesterol with Stroke Risk, Severity and Prognosis

Zhou

Liu

et al. 2020

JAT

To investigate the association of small dense low-density lipoprotein cholesterol (sdLDL-C) and acute ischemic stroke (AIS) in terms of risk, severity, and outcomes. Prediction models were established to screen high-risk patients and predict prognosis of AIS patients. Methods: We enrolled in this study 355 AIS patients and 171 non-AIS controls. AIS was subtyped according to TOAST criteria, and the severity and outcomes of AIS were measured. Blood glucose and lipid profiles including total cholesterol, triglyceride, and lipoproteins were measured in all patients using automatic measure. Lipoprotein subfractions were detected by the Lipoprint LDL system. Results: As compared with the non-AIS control group, the AIS group had higher sdLDL-C levels. Pearson correlation analysis revealed that the sdLDL-C level and risk of AIS, especially non-cardioembolic stroke, were positively correlated. The area under the curve of sdLDL-C for AIS risk was 0.665, better than that of other lipids. Additionally, the sdLDL-C level was significantly correlated with AIS severity and bad outcomes. A logistic regression model for assessing the probability of AIS occurrence and a prognostic prediction model were established based on sdLDL-C and other variables. Conclusions: Elevated levels of sdLDL-C were associated with a higher prevalence of AIS, especially in non-cardioembolic stroke subtypes. After adjustment for other risk factors, sdLDL-C was found to be an independent risk factor for AIS. Also, sdLDL-C level was strongly associated with AIS severity and poor functional outcomes. Logistic regression models for AIS risk and prognosis prediction were established to help clinicians provide better prevention for high-risk subjects and monitor their prognosis. stroke deaths occur in the developing countries 2). China bears the biggest stroke burden in the world, and stroke becomes the leading cause of death in China 3). In China, about 20% of overall deaths could be attributed to stroke and more than 2 million new Copyright©2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.

“…Besides, LDL-3, LDL-studies by Zeljkovic et al and Kayran et al The former Serbia group examined LDL subclasses in 200 AIS patients as well as 162 controls, showing that AIS patients had signi cantly more LDL III and IVb subclasses (sd-LDL), but less large LDL I and II particles [16]. The latter, however, recruited 110 AIS patients and 60 healthy controls from Turkey in the study, and reported that apart from LDL-3 and LDL-4, the level of large LDL-2 particles was also signi cantly higher in AIS patients [17]. The distribution of large LDLs (LDL-1 and LDL-2) between AIS and control group is in controversy though, all three studies demonstrated a signi cant elevation of sd-LDLs, especially LDL-3 and LDL-4 levels in the AIS patients.…”

Section: Discussionmentioning

confidence: 91%

Estimation of the LDL Subclasses in Ischemic Stroke as a Risk Factor in a Chinese population

Duan

Xue

et al. 2020

Preprint

Background: Acute ischemic stroke (AIS) is one of the leading causes of mortality and long-term disability worldwide. Our study aims to clarify the role of low-density lipoproteins (LDL) subclasses in the occurrence of AIS and develop a risk prediction model based on these characteristics to identify high-risk people.Methods: Five hundred and sixty-six patients with AIS and 197 non-AIS controls were included in this study. Serum lipids and other baseline characteristics including fasting blood glucose (GLU), serum creatinine (Scr), and blood pressure were investigated in relation to occurrence of AIS. The LDL subfractions were classified and measured with the Lipoprint System by a polyacrylamide gel electrophoresis technique.Results: Levels of LDL-3, LDL-4 and LDL-5 subclasses were significantly higher in the AIS group compared to the non-AIS group and lower level of LDL-1 was prevalent in the AIS patients. Consistently, Spearman correlation coefficient demonstrated that sd‐demonevels, especially LDL-3 and LDL-4 levels, were significantly positively correlated with AIS. Furthermore, there is a significant positive correlation between small dense LDL (sd-LDL, that is LDL-3 to 7) levels and serum lipids including total cholesterol (TC), Low density lipoprotein cholesterol (LDL‐C), and Triglyceride (TG). Increased LDL-3 and LDL-4 as well as decreased LDL-1 and LDL-2 were correlated to the occurrence of AIS, even in the people with normal LDL-C levels. A new prediction model including 12 variables can accurately predict the AIS risk in Chinese patients (AUC=0.82±0.04).Conclusions: Levels of LDL subclasses should be considered in addition to serum LDL-C in assessment and management of AIS. A new prediction model based on clinical variables including LDL subtractions can help clinicians identify high of AIS, even in the people with norm.