Xiangyang No.1 People's Hospital, Hubei University of Medicine.
Ruijin Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine.
J Atheroscler Thromb. 2020 Dec 1;27(12):1310-1324. doi: 10.5551/jat.53132. Epub 2020 Feb 15.
To investigate the association of small dense low-density lipoprotein cholesterol (sdLDL-C) and acute ischemic stroke (AIS) in terms of risk, severity, and outcomes. Prediction models were established to screen high-risk patients and predict prognosis of AIS patients.
We enrolled in this study 355 AIS patients and 171 non-AIS controls. AIS was subtyped according to TOAST criteria, and the severity and outcomes of AIS were measured. Blood glucose and lipid profiles including total cholesterol, triglyceride, and lipoproteins were measured in all patients using automatic measure. Lipoprotein subfractions were detected by the Lipoprint LDL system.
As compared with the non-AIS control group, the AIS group had higher sdLDL-C levels. Pearson correlation analysis revealed that the sdLDL-C level and risk of AIS, especially non-cardioembolic stroke, were positively correlated. The area under the curve of sdLDL-C for AIS risk was 0.665, better than that of other lipids. Additionally, the sdLDL-C level was significantly correlated with AIS severity and bad outcomes. A logistic regression model for assessing the probability of AIS occurrence and a prognostic prediction model were established based on sdLDL-C and other variables.
Elevated levels of sdLDL-C were associated with a higher prevalence of AIS, especially in non-cardioembolic stroke subtypes. After adjustment for other risk factors, sdLDL-C was found to be an independent risk factor for AIS. Also, sdLDL-C level was strongly associated with AIS severity and poor functional outcomes. Logistic regression models for AIS risk and prognosis prediction were established to help clinicians provide better prevention for high-risk subjects and monitor their prognosis.
探讨小而密低密度脂蛋白胆固醇（sdLDL-C）与急性缺血性脑卒中（AIS）在风险、严重程度和结局方面的关系。建立预测模型以筛选高危患者并预测 AIS 患者的预后。
我们纳入了 355 例 AIS 患者和 171 例非 AIS 对照。根据 TOAST 标准对 AIS 进行分型，并测量 AIS 的严重程度和结局。所有患者均采用自动测量法检测血糖和血脂谱，包括总胆固醇、甘油三酯和脂蛋白。脂蛋白亚组分采用 Lipoprint LDL 系统检测。
与非 AIS 对照组相比，AIS 组的 sdLDL-C 水平更高。Pearson 相关分析显示，sdLDL-C 水平与 AIS 风险，特别是非心源性脑卒中等呈正相关。sdLDL-C 预测 AIS 风险的曲线下面积为 0.665，优于其他脂质。此外，sdLDL-C 水平与 AIS 严重程度和不良结局显著相关。根据 sdLDL-C 及其他变量建立了评估 AIS 发生概率的逻辑回归模型和预后预测模型。
sdLDL-C 水平升高与 AIS 患病率升高相关，尤其是非心源性脑卒中等亚型。校正其他危险因素后，sdLDL-C 是 AIS 的独立危险因素。此外，sdLDL-C 水平与 AIS 严重程度和不良功能结局密切相关。建立了 AIS 风险和预后预测的逻辑回归模型，有助于临床医生为高危人群提供更好的预防措施，并监测其预后。
