Arauz A, Romano J G, Ruiz-Franco A, Shang T, Dong C, Rundek T, Koch S, Hernández-Curiel B, Pacheco J, Rojas P, Ruiz-Navarro F, Katsnelson M, Sacco R L
Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.
Int J Stroke. 2014 Jun;9(4):394-9. doi: 10.1111/ijs.12239. Epub 2013 Dec 19.
The study aims to compare lipid profiles among ischemic stroke patients in a predominantly Caribbean-Hispanic population in Miami and a Mestizo Hispanic population in Mexico City.
We analyzed ischemic stroke Hispanic patients with complete baseline fasting lipid profile enrolled contemporaneously in the prospective registries of two tertiary care teaching hospitals in Mexico City and Miami. Demographic characteristics, risk factors, medications, ischemic stroke subtype, and first fasting lipid profile were compared. Vascular risk factor definitions were standardized. Multiple linear regression analysis was performed to compare lipid fractions.
A total of 324 patients from Mexico and 236 from Miami were analyzed. Mexicans were significantly younger (58 · 1 vs. 67 · 4 years), had a lower frequency of hypertension (53 · 4% vs. 79 · 7%), and lower body mass index (27 vs. 28 · 5). There was a trend toward greater prevalence of diabetes in Mexicans (31 · 5 vs. 24 · 6%, P = 0 · 07). Statin use at the time of ischemic stroke was more common in Miami Hispanics (18 · 6 vs. 9 · 4%). Mexicans had lower total cholesterol levels (169 · 9 ± 46 · 1 vs. 179 · 9 ± 48 · 4 mg/dl), lower low-density lipoprotein (92 · 3 ± 37 · 1 vs. 108 · 2 ± 40 · 8 mg/dl), and higher triglyceride levels (166 · 9 ± 123 · 9 vs. 149 · 2 ± 115 · 2 mg/dl). These differences remained significant after adjusting for age, gender, hypertension, diabetes, body mass index, smoking, ischemic stroke subtype, and statin use.
We found significant differences in lipid fractions in Hispanic ischemic stroke patients, with lower total cholesterol and low-density lipoprotein, and higher triglyceride levels in Mexicans. These findings highlight the heterogeneity of dyslipidemia among the Hispanic race-ethnic group and may lead to different secondary prevention strategies.
本研究旨在比较迈阿密以加勒比裔西班牙人为主的人群和墨西哥城梅斯蒂索西班牙人群中缺血性中风患者的血脂谱。
我们分析了同时纳入墨西哥城和迈阿密两家三级医疗教学医院前瞻性登记处的具有完整基线空腹血脂谱的缺血性中风西班牙裔患者。比较了人口统计学特征、危险因素、用药情况、缺血性中风亚型和首次空腹血脂谱。血管危险因素的定义进行了标准化。进行多元线性回归分析以比较血脂成分。
共分析了来自墨西哥的324例患者和来自迈阿密的236例患者。墨西哥人明显更年轻（58.1岁对67.4岁），高血压发生率更低（53.4%对79.7%），体重指数更低（27对28.5）。墨西哥人糖尿病患病率有更高的趋势（31.5%对24.6%，P = 0.07）。缺血性中风发生时他汀类药物的使用在迈阿密西班牙裔中更常见（18.6%对9.4%）。墨西哥人的总胆固醇水平更低（169.9±46.1对179.9±48.4mg/dl），低密度脂蛋白更低（92.3±37.1对108.2±40.8mg/dl），甘油三酯水平更高（166.9±123.9对149.2±115.2mg/dl）。在调整年龄、性别、高血压、糖尿病、体重指数、吸烟、缺血性中风亚型和他汀类药物使用后，这些差异仍然显著。
我们发现西班牙裔缺血性中风患者的血脂成分存在显著差异，墨西哥人的总胆固醇和低密度脂蛋白更低，甘油三酯水平更高。这些发现凸显了西班牙裔种族群体中血脂异常的异质性，可能导致不同的二级预防策略。
