From the Neurovascular Unit for Translational and Therapeutics Research (D. Ní C., M.M., L.A., Á.M., E.F., G.H., S.M., K. O'Rourke, P.J.K.) and the Departments of Vascular Surgery (K. O'Malley, M. O'Donohoe, C.M.) and Radiology (E.K., M. O'Connell), Mater University Hospital/University College Dublin; Connolly Hospital (E.D.); and St Vincent's University Hospital (I.N., M.B., M.C.), Dublin, Ireland.
Neurology. 2014 May 13;82(19):1693-9. doi: 10.1212/WNL.0000000000000408. Epub 2014 Apr 11.
We hypothesized that serum lipids, which experimental data suggest may be key initiators of carotid plaque inflammation, would be associated with plaque inflammation on (18)fluorodeoxyglucose (FDG)-PET in patients with acutely symptomatic carotid stenosis.
In this cohort study, consecutive patients with acute symptomatic internal carotid artery (ICA) stenosis (≥50%) underwent carotid PET-CT. We quantified plaque FDG uptake as follows: (1) average maximum standardized uptake values (SUVmax) across 10 regions of interest (ROI); (2) highest single ROI SUV measure (SUVROImax); (3) averaged mean SUV across 10 ROIs (SUVmean).
Sixty-one patients were included. Plaque inflammatory FDG SUVmax was associated with increasing tertiles of low-density lipoprotein (LDL) (trend p = 0.004), total cholesterol (p = 0.009), and triglycerides (p = 0.01), and with lower high-density lipoprotein (HDL) (p = 0.005). When analyzed as a continuous variable, LDL was associated with symptomatic ICA SUVmean (Spearman rho 0.44, p = 0.009), SUVROImax (rho 0.33, p = 0.01), and SUVmax (rho 0.35, p = 0.06). Total cholesterol was associated with SUVmean (rho 0.33, p = 0.009), with trends for SUVmax (rho 0.24, p = 0.059) and SUVROImax (rho 0.23, p = 0.08). Triglycerides were associated with SUVmax (rho 0.32, p = 0.01) and SUVROImax (rho 0.35, p = 0.005). HDL was associated with lower SUVmax (rho -0.37, p = 0.004) and SUVROImax (rho -0.44, p = 0.0004). On multivariable linear regression analysis adjusting for age, sex, degree of carotid stenosis, statins, and smoking, LDL (p = 0.008) and total cholesterol (p = 0.04) were independently associated with SUVmax.
Serum LDL and total cholesterol were associated with acutely symptomatic carotid plaque FDG uptake, supporting experimental data suggesting lipids may promote plaque inflammation, mediating rupture and clinical events.
我们假设，实验数据表明可能是颈动脉斑块炎症关键启动因素的血清脂质，与急性症状性颈动脉狭窄患者的（18）氟脱氧葡萄糖（FDG）-PET 上的斑块炎症相关。
在这项队列研究中，连续的急性症状性颈内动脉（ICA）狭窄（≥50%）患者接受了颈动脉 PET-CT 检查。我们通过以下方式量化斑块 FDG 摄取：（1）10 个感兴趣区域（ROI）的平均最大标准化摄取值（SUVmax）；（2）最高单 ROI SUV 测量值（SUVROImax）；（3）10 个 ROI 的平均平均 SUV（SUVmean）。
共纳入 61 例患者。斑块炎症 FDG SUVmax 与 LDL（趋势 p = 0.004）、总胆固醇（p = 0.009）和甘油三酯（p = 0.01）的低密度脂蛋白（LDL）递增三分位数相关，与高密度脂蛋白（HDL）降低相关（p = 0.005）。当作为连续变量进行分析时，LDL 与症状性 ICA SUVmean（Spearman rho 0.44，p = 0.009）、SUVROImax（rho 0.33，p = 0.01）和 SUVmax（rho 0.35，p = 0.06）相关。总胆固醇与 SUVmean 相关（rho 0.33，p = 0.009），与 SUVmax（rho 0.24，p = 0.059）和 SUVROImax（rho 0.23，p = 0.08）的趋势相关。甘油三酯与 SUVmax（rho 0.32，p = 0.01）和 SUVROImax（rho 0.35，p = 0.005）相关。HDL 与 SUVmax（rho -0.37，p = 0.004）和 SUVROImax（rho -0.44，p = 0.0004）呈负相关。在调整年龄、性别、颈动脉狭窄程度、他汀类药物和吸烟因素的多变量线性回归分析中，LDL（p = 0.008）和总胆固醇（p = 0.04）与 SUVmax 独立相关。
血清 LDL 和总胆固醇与急性症状性颈动脉斑块 FDG 摄取相关，支持实验数据表明脂质可能促进斑块炎症，介导破裂和临床事件。
