Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
PLoS One. 2013 May 29;8(5):e65229. doi: 10.1371/journal.pone.0065229. Print 2013.
The aim of this study was to assess the association between non-high-density-lipoprotein-cholesterol (non-HDL-C) and the prevalence of asymptomatic intracranial arterial stenosis (ICAS).
The Asymptomatic Polyvascular Abnormalities Community (APAC) study is a prospective cohort study based on the Kailuan district (China) population. A total of 5351 eligible subjects, aged ≥40, and without history of stroke or myocardial infarction, were enrolled in this study. Transcranial Doppler Ultrasonography (TCD) was performed on all enrolled subjects for the evaluation of ICAS presence. Out of 5351 patients, 698 subjects showed evidence of ICAS (prevalence of 13.04%). Multivariate analysis showed that non-HDL-C is an independent indicator for the presence of ICAS (OR = 1.15, 95%CI: 1.08 - 1.23), but with a gender difference (P for interaction<0.01): in men, non-HDL-C is an independent indicator for ICAS (multivariate-adjusted OR = 1.28, 95%CI: 1.18-1.39), but not in women (multivariate-adjusted OR = 1.03, 95%CI: 0.93-1.14). Subjects were divided into five subgroups based non-HDL-C levels and these levels correlated linearly with the prevalence of ICAS (P for trend <0.01). Compared with the first quintile, multivariate-adjusted OR (95%CI) of the second, third, fourth and fifth quintiles were: 1.05 (0.71-1.56), 1.33 (0.91-1.95), 1.83 (1.27-2.63), 2.48 (1.72-3.57), respectively.
Non-HDL-C is an independent predictor of ICAS prevalence in men but not in women, suggesting that non-HDL-C levels could be used as a surveillance factor in the primary prevention of ischemic stroke, especially in men.
本研究旨在评估非高密度脂蛋白胆固醇（non-HDL-C）与无症状颅内动脉狭窄（ICAS）患病率之间的关系。
无症状多血管异常社区（APAC）研究是一项基于开滦矿区（中国）人群的前瞻性队列研究。共纳入 5351 名年龄≥40 岁且无卒中或心肌梗死病史的合格受试者，对所有纳入的受试者进行经颅多普勒超声（TCD）检查，以评估 ICAS 的存在。在 5351 例患者中，698 例患者存在 ICAS（患病率为 13.04%）。多变量分析显示，非 HDL-C 是 ICAS 存在的独立指标（OR=1.15，95%CI：1.08-1.23），但存在性别差异（P 交互<0.01）：在男性中，非 HDL-C 是 ICAS 的独立指标（多变量调整后的 OR=1.28，95%CI：1.18-1.39），但在女性中并非如此（多变量调整后的 OR=1.03，95%CI：0.93-1.14）。根据非 HDL-C 水平将受试者分为五组，这些水平与 ICAS 的患病率呈线性相关（趋势 P<0.01）。与第一五分位数相比，第二、三、四和五分位数的多变量调整后 OR（95%CI）分别为：1.05（0.71-1.56）、1.33（0.91-1.95）、1.83（1.27-2.63）、2.48（1.72-3.57）。
非 HDL-C 是男性而非女性 ICAS 患病率的独立预测因子，提示非 HDL-C 水平可作为缺血性卒中一级预防的监测因素，尤其是在男性中。
