Ohira Tetsuya, Schreiner Pamela J, Morrisett Joel D, Chambless Lloyd E, Rosamond Wayne D, Folsom Aaron R
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Stroke. 2006 Jun;37(6):1407-12. doi: 10.1161/01.STR.0000222666.21482.b6. Epub 2006 May 4.
Numerous case-control and cross-sectional studies have reported higher median lipoprotein(a) [Lp(a)] levels among stroke patients than controls, but existing prospective studies have not consistently shown an association. We sought to examine the relationship between plasma Lp(a) levels and the incidence of ischemic stroke among blacks and whites.
Between 1987 and 1989, 14,221 men and women (3647 blacks and 10,574 whites) aged 45 to 64 years and free of clinical cardiovascular disease, took part in the first examination of the Atherosclerosis Risk in Communities (ARIC) study cohort. Lp(a) and other risk factors for cardiovascular disease were measured at baseline.
During the 13.5-year follow-up, 496 ischemic strokes occurred. Participants with Lp(a) > or =300 microg/mL had a 79% higher age, sex, and race-adjusted rate ratio (RR) of ischemic stroke than did those with Lp(a) levels <100 microg/mL. Compared with Lp(a) <100 microg/mL, the multivariate adjusted RRs for Lp(a) > or =300 microg/mL were 1.84 (95% CI, 1.05 to 3.07) in black women, 1.72 (95% CI, 0.86 to 3.48) in black men, 2.42 (95% CI, 1.30 to 4.53) in white women, and 1.18 (95% CI, 0.47 to 2.90) in white men. There was no significant increment in the RRs for 100 to 199 microg/mL and 200 to 299 microg/mL groups.
A high Lp(a) concentration is associated with a higher incidence of ischemic stroke in blacks and white women, but not in white men.
众多病例对照研究和横断面研究报告称，与对照组相比，中风患者的脂蛋白(a)[Lp(a)]水平中位数更高，但现有的前瞻性研究并未始终显示出这种关联。我们试图研究黑人和白人血浆Lp(a)水平与缺血性中风发病率之间的关系。
1987年至1989年间，14221名年龄在45至64岁之间且无临床心血管疾病的男性和女性（3647名黑人，10574名白人）参与了社区动脉粥样硬化风险（ARIC）研究队列的首次检查。在基线时测量了Lp(a)和其他心血管疾病风险因素。
在13.5年的随访期间，发生了496例缺血性中风。Lp(a)≥300μg/mL的参与者发生缺血性中风的年龄、性别和种族调整率比（RR）比Lp(a)水平<100μg/mL的参与者高79%。与Lp(a)<100μg/mL相比，Lp(a)≥300μg/mL的多变量调整RR在黑人女性中为1.84（95%CI，1.05至3.07），在黑人男性中为1.72（95%CI，0.86至3.48），在白人女性中为2.42（95%CI，1.30至4.53），在白人男性中为1.18（95%CI，0.47至2.90）。100至199μg/mL和200至299μg/mL组的RR没有显著增加。
高Lp(a)浓度与黑人和白人女性缺血性中风发病率较高相关，但与白人男性无关。
