Wityk R J, Kittner S J, Jenner J L, Hebel J R, Epstein A, Wozniak M A, Stolley P D, Stern B J, Sloan M A, Price T R, McCarter R J, Macko R F, Johnson C J, Earley C J, Buchholz D W, Schaefer E J
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Atherosclerosis. 2000 Jun;150(2):389-96. doi: 10.1016/s0021-9150(99)00388-3.
lipoprotein (a) (lp (a)) is a lipid-containing particle similar to LDL which has been found in atherosclerotic plaque. The role of lp (a) in ischemic stroke remains controversial, but some studies suggest lp (a) is particularly important as a risk factor for stroke in young adults. We investigated the role of lp (a) as a risk factor for stroke in young women enrolled in the Stroke Prevention in Young Women Study.
subjects were participants in a population-based, case-control study of risk factors for ischemic stroke in young women. Cases were derived from surveillance of 59 regional hospitals in the central Maryland, Washington DC, Pennsylvania and Delaware area. Lp (a) was measured in 110 cases and 216 age-matched controls. Demographics, risk factors, and stroke subtype were determined by interview and review of medical records.
lp (a) values were higher in blacks than whites, but within racial groups, the distribution of lp (a) values was similar between cases and controls. After adjustment for age, race, hypertension, diabetes, cigarette smoking, coronary artery disease, total cholesterol and HDL cholesterol, the odds ratio for an association of lp (a) and stroke was 1.36 (95% CI 0.80-2.29). There was no dose-response relationship between lp (a) quintile and stroke risk. Among stroke subtypes, only lacunar stroke patients had significantly elevated lp (a) values compared to controls.
we found no association of lp (a) with stroke in a population of young women with ischemic stroke. Small numbers of patients limit conclusions regarding risk in ischemic stroke subtypes, but we could not confirm previous suggestions of an association of lp (a) with atherosclerotic stroke in young adults.
脂蛋白(a)[Lp(a)]是一种含脂质的颗粒，类似于低密度脂蛋白（LDL），已在动脉粥样硬化斑块中发现。Lp(a)在缺血性卒中中的作用仍存在争议，但一些研究表明，Lp(a)作为年轻成年人卒中的危险因素尤为重要。我们在年轻女性卒中预防研究中调查了Lp(a)作为年轻女性卒中危险因素的作用。
研究对象参与了一项基于人群的年轻女性缺血性卒中危险因素病例对照研究。病例来自对马里兰州中部、华盛顿特区、宾夕法尼亚州和特拉华州地区59家区域医院的监测。对110例病例和216例年龄匹配的对照者进行了Lp(a)检测。通过访谈和查阅病历确定人口统计学特征、危险因素和卒中亚型。
黑人的Lp(a)值高于白人，但在种族群体内部，病例组和对照组的Lp(a)值分布相似。在调整年龄、种族、高血压、糖尿病、吸烟、冠状动脉疾病、总胆固醇和高密度脂蛋白胆固醇后，Lp(a)与卒中关联的比值比为1.36（95%可信区间0.80 - 2.29）。Lp(a)五分位数与卒中风险之间无剂量反应关系。在卒中亚型中，与对照组相比，仅腔隙性卒中患者的Lp(a)值显著升高。
在患有缺血性卒中的年轻女性人群中，我们未发现Lp(a)与卒中存在关联。患者数量较少限制了关于缺血性卒中亚型风险的结论，但我们无法证实之前关于Lp(a)与年轻成年人动脉粥样硬化性卒中存在关联的观点。
