Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (M.K., S.A.A., J.D.F., K.J.M., M.K.J.).
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (S.A.A.).
Stroke. 2022 Apr;53(4):1292-1300. doi: 10.1161/STROKEAHA.121.034299. Epub 2021 Oct 14.
Whether HDL (high-density lipoprotein) is associated with risk of vascular brain injury is unclear. HDL is comprised of many apo (apolipoprotein) species, creating distinct subtypes of HDL.
We utilized sandwich ELISA to determine HDL subspecies from plasma collected in 1998/1999 from 2001 CHS (Cardiovascular Health Study) participants (mean age, 80 years).
In cross-sectional analyses, participants with higher apoA1 in plasma and lower apoE in HDL were less likely to have prevalent covert magnetic resonance imaging-defined infarcts: odds ratio for apoA1 Q4 versus Q1, 0.68 (95% CI, 0.50-0.93), and odds ratio for apoE Q4 versus Q1, 1.36 (95% CI, 1.01-1.84). Similarly, apoA1 in the subspecies of HDL that lacked apoC3, apoJ, or apoE was inversely related to covert infarcts, and apoE in the subspecies of HDL that lacked apoC3 or apoJ was directly related to covert infarcts in prospective analyses. In contrast, the concentrations of apoA1 and apoE in the complementary subspecies of HDL that contained these apos were unrelated to covert infarcts. Patterns of associations between incident overt ischemic stroke and apoA1, apoE, and apoA1 and apoE in subspecies of HDL were similar to those observed for covert infarcts but less pronounced.
This study highlights HDL subspecies defined by apo content as relevant biomarkers of covert and overt vascular brain injury.
高密度脂蛋白（HDL）是否与血管性脑损伤风险相关尚不清楚。HDL 由许多载脂蛋白（apo）组成，形成了不同的 HDL 亚型。
我们利用夹心 ELISA 法，从 2001 年心血管健康研究（CHS）参与者在 1998/1999 年采集的血浆中确定 HDL 亚组分（平均年龄 80 岁）。
在横断面分析中，血浆中载脂蛋白 A1 水平较高、HDL 中载脂蛋白 E 水平较低的患者发生隐匿性磁共振成像定义的梗死的可能性较低：载脂蛋白 A1 Q4 与 Q1 相比，比值比为 0.68（95%CI：0.50-0.93），载脂蛋白 E Q4 与 Q1 相比，比值比为 1.36（95%CI：1.01-1.84）。同样，缺乏载脂蛋白 C3、载脂蛋白 J 或载脂蛋白 E 的 HDL 亚组分中的载脂蛋白 A1 与隐匿性梗死呈负相关，而缺乏载脂蛋白 C3 或载脂蛋白 J 的 HDL 亚组分中的载脂蛋白 E 与隐匿性梗死呈正相关。相比之下，含有这些载脂蛋白的 HDL 的互补亚组分中的载脂蛋白 A1 和载脂蛋白 E 浓度与隐匿性梗死无关。载脂蛋白 A1、载脂蛋白 E 和 HDL 亚组分中的载脂蛋白 A1 和载脂蛋白 E 与新发显性缺血性卒中之间的关联模式与隐匿性梗死相似，但程度较轻。
本研究强调了根据 apo 含量定义的 HDL 亚组分是隐匿性和显性血管性脑损伤的相关生物标志物。
