Kang Kaijiang, Wang Yu, Wu Jianwei, Wang Anxin, Zhang Jia, Xu Jie, Ju Yi, Zhao Xingquan
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Front Neurol. 2020 Nov 26;11:555274. doi: 10.3389/fneur.2020.555274. eCollection 2020.
Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical or subclinical ischemic events, while the relationship between low-density lipoprotein cholesterol (LDL-C) measured at a single time point and intracranial atherosclerotic stenosis (ICAS) is inconsistent. This study aims to assess the association between cumulative exposure to increased LDL-C and the prevalence of asymptomatic ICAS. The Asymptomatic Polyvascular Abnormalities Community study was investigated on the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. In this study, we included 4,523 participants with LDL-C measured at 3 examinations in 2006, 2008, and 2010. Cumulative exposure to increased LDL-C was calculated as following: LDL-C burden = [(LDL-C-1.8) + (LDL-C-1.8)]/2 time; LDL-C burden = LDL-C burden + LDL-C burden. Transcranial doppler ultrasonography was performed in 2010 to detecting the ICAS. Of the 4,347 patients, 13.3% (580/4,347) were diagnosed with ICAS. In univariate analysis, the association between LDL-C burden and ICAS prevalence was significant, the odds ratios (95% confidence interval) from the lowest to the highest quartile were 1 (reference), 1.30 (0.99-1.70), 1.32 (1.01-1.73), and 2.14 (1.66-2.75), respectively ( < 0.05). After adjustment for potential confounding factors, the same result was reached. Cumulative exposure to increased LDL-C is concentration-dependently associated with increased prevalence of asymptomatic ICAS, especially in those under the age of 65 y or free of hypertension, diabetes mellitus, and hyperlipidemia.
由于复发性临床或亚临床缺血事件的高风险，颅内动脉粥样硬化越来越受到关注，而单次测量的低密度脂蛋白胆固醇（LDL-C）与颅内动脉粥样硬化狭窄（ICAS）之间的关系并不一致。本研究旨在评估累积暴露于升高的LDL-C与无症状ICAS患病率之间的关联。无症状多血管异常社区研究调查了中国成年人无症状多血管异常的流行病学。在本研究中，我们纳入了4523名参与者，他们在2006年、2008年和2010年的3次检查中测量了LDL-C。累积暴露于升高的LDL-C的计算方法如下：LDL-C负荷 = [（LDL-C - 1.8）+（LDL-C - 1.8）]/2×次数；LDL-C负荷 = LDL-C负荷 + LDL-C负荷。2010年进行经颅多普勒超声检查以检测ICAS。在4347名患者中，13.3%（580/4347）被诊断为ICAS。在单因素分析中，LDL-C负荷与ICAS患病率之间的关联显著，从最低到最高四分位数的优势比（95%置信区间）分别为1（参考值）、1.30（0.99 - 1.70）、1.32（1.01 - 1.73）和2.14（1.66 - 2.75）（P < 0.05）。在调整潜在混杂因素后，得出了相同的结果。累积暴露于升高的LDL-C与无症状ICAS患病率的增加呈浓度依赖性相关，尤其是在65岁以下或无高血压、糖尿病和高脂血症的人群中。
