Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China.
BMC Neurol. 2020 Feb 7;20(1):47. doi: 10.1186/s12883-020-1615-9.
It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT.
We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis.
A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted odds ratios [ORs] 1.74 [95% confidence interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend = 0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age (P for interaction = 0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values [Non-HDL-C, net reclassification index (NRI) 0.24, 95%CI 0.17-0.31, P < 0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P = 0.03].
Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT.
非高密度脂蛋白胆固醇（Non-HDL-C）与急性缺血性脑卒中（AIS）后出血性转化（HT）的关系尚不清楚。本研究旨在探讨 Non-HDL-C 与 HT 的相关性，并比较 Non-HDL-C 和低密度脂蛋白胆固醇（LDL-C）对 HT 的预测价值。
我们连续纳入发病 7 天内的 AIS 患者。根据 Non-HDL-C 的四分位区间将参与者分为四组。通过随访脑影像学评估 HT。我们在多变量 logistic 回归分析中评估 Non-HDL-C、LDL-C 与 HT 之间的相关性。
共纳入 2043 例患者，其中 232 例发生 HT。与 Non-HDL-C 最高四分位数相比，Non-HDL-C 的第一、第二和第三四分位数与 HT 风险增加相关（校正比值比[OR] 1.74[95%置信区间[CI] 1.09-2.78]、2.01[95%CI 1.26-3.20]和 1.76[95%CI 1.10-2.83]，P 趋势=0.024）。LDL-C 也有类似结果。Non-HDL-C 与年龄之间存在显著交互作用（P 交互=0.021）。将 Non-HDL-C 和 LDL-C 加入常规因素后，预测值显著提高[Non-HDL-C，净重新分类指数（NRI）0.24，95%CI 0.17-0.31，P<0.001；LDL-C，NRI 0.15，95%CI 0.08-0.22，P=0.03]。
低 Non-HDL-C 与 HT 风险增加相关。此外，Non-HDL-C 对预测 HT 的作用与 LDL-C 相似。
