Increase in plasma malondialdehyde-modified low-density lipoprotein in patients with atherothrombotic cerebral infarction.

Oxidized low-density lipoprotein cholesterol (Ox-LDL) is considered to play a critical role in the pathogenesis of atherosclerosis. We investigated the role of malondialdehyde-modified LDL (MDA-LDL), an indicator of Ox-LDL, in cerebral infarction. We also investigated the relationship between MDA-LDL and atherosclerotic change of the carotid artery. Subjects were 30 patients with lacunar infarction (LA), 19 patients with atherothrombotic infarction (AT) and 48 controls. Carotid arteries were evaluated with B-mode Doppler ultrasonography. The intima-media thickness (IMT) was considered to be increased if its value was more than 1.1 mm. The level of MDA-LDL concentration was significantly (P < 0.05) elevated in AT patients (129.96 +/- 27.88 U/I) than in LA patients (99.35 +/- 34.06 U/l) and controls (97.65 +/- 32.61 U/l). Among AT patients, plasma level of MDA-LDL concentration was statistically significantly elevated in the group with increased IMT (139.7 +/- 24.5 U/l) than in the group without increased IMT (102.7 +/- 17.2 U/l). No statistically significant difference was found among LA patients. However, there was no difference in LDL-C concentration between the patients with and without IMT thickening among LA or AT patients. The concentration of MDA-LDL was significantly decreased (P < 0.05) after statin administration for 5-6 months. MDA-LDL, namely degraded or qualitatively changed LDL-C, appears to be related to atherosclerotic change of the carotid artery in AT patients.