Qinghai University, Xining, 810000, China.
Qinghai Provincial People's Hospital, Xining, 810000, China.
Neurol Sci. 2023 Mar;44(3):835-843. doi: 10.1007/s10072-022-06472-3. Epub 2022 Oct 27.
Lipid abnormalities are important risk factors in patients with large atherosclerotic strokes. Recent studies have shown that non-traditional lipid parameters are crucial to the development of atherosclerosis and are closely related to the clinical outcome of acute ischemic stroke (AIS). Therefore, we aimed to investigate the relationship between non-traditional lipid parameters and carotid plaque stability and stenosis degree in patients with large atherosclerotic stroke.
We retrospectively analyzed 336 patients with AIS. All patients were divided into the non-plaque group, stable plaque group, and vulnerable plaque group according to ultrasound examination. At the same time, the patients were divided into non-stenosis, mild stenosis, moderate stenosis, and severe stenosis groups according to the degree of stenosis. Non-traditional lipid parameters, including residual lipoprotein cholesterol (RLP-C), non-high-density lipoprotein cholesterol (non-HDL-C), non-HDL-C to high-density lipoprotein cholesterol ratio (non-HDL-C/HDL-C), triglyceride to HDL-C ratio (TG/HDL-C), Castelli's risk index (CRI), and the atherogenic index of plasma (AIP). Receiver operating characteristic (ROC) curves and multivariate logistic regression analyses were used to investigate the associations between the non-traditional lipid parameters and carotid plaque vulnerability. Spearman linear correlation analysis was used to test the correlation between variables and the degree of carotid plaque stenosis.
This study population included 336 patients with AIS, of whom 294 had a carotid plaque. Multivariate logistic regression model showed that RLP-C (OR, 3.361; 95%CI, 1.311-8.617), non-HDL-C/HDL-C (OR, 1.699; 95%CI, 1.279-2.258), non-HDL-C (OR, 1.704; 95%CI, 1.143-2.540), CRI-I (OR, 1.573; 95%CI, 1.196-2.068), and CRI-II (OR, 2.022; 95%CI, 1.369-2.985) were independent risk factors for carotid plaque vulnerability. In addition, Spearman correlation analysis showed that the values of RLP-C, non-HDL-C/HDL-C, non-HDL-C, TG/HDL-C, CRI-I, CRI-II, and AIP on admission were positively correlated with the degree of carotid plaque stenosis (all P < 0.001).
This study provides evidence that non-traditional lipid parameters (LP-C, non-HDL-C/HDL-C, non-HDL-C, CRI-I, and CRI-II) were potential predictors of carotid plaque vulnerability in patients with AIS. However, no significant correlation was observed between TG/HDL-C and AIP. RLP-C, non-HDL-C/HDL-C, non-HDL-C, TG/HDL-C, CRI-I, CRI-II, and AIP were closely related to the degree of carotid plaque stenosis. Non-traditional lipid parameters can be used as novel biomarkers of carotid plaque vulnerability and stenosis.
脂质异常是大血管粥样硬化性卒中患者的重要危险因素。最近的研究表明，非传统脂质参数对于动脉粥样硬化的发展至关重要，并且与急性缺血性卒中（AIS）的临床转归密切相关。因此，我们旨在探讨非传统脂质参数与大血管粥样硬化性卒中患者颈动脉斑块稳定性和狭窄程度的关系。
我们回顾性分析了 336 例 AIS 患者。所有患者根据超声检查分为无斑块组、稳定斑块组和易损斑块组。同时，根据狭窄程度将患者分为无狭窄、轻度狭窄、中度狭窄和重度狭窄组。非传统脂质参数包括残余脂蛋白胆固醇（RLP-C）、非高密度脂蛋白胆固醇（non-HDL-C）、非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（non-HDL-C/HDL-C）、甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、Castelli 风险指数（CRI）和血浆致动脉粥样硬化指数（AIP）。采用受试者工作特征（ROC）曲线和多变量 logistic 回归分析探讨非传统脂质参数与颈动脉斑块易损性的关系。Spearman 线性相关分析用于检验变量与颈动脉斑块狭窄程度之间的相关性。
本研究人群包括 336 例 AIS 患者，其中 294 例有颈动脉斑块。多变量 logistic 回归模型显示，RLP-C（OR，3.361；95%CI，1.311-8.617）、non-HDL-C/HDL-C（OR，1.699；95%CI，1.279-2.258）、non-HDL-C（OR，1.704；95%CI，1.143-2.540）、CRI-I（OR，1.573；95%CI，1.196-2.068）和 CRI-II（OR，2.022；95%CI，1.369-2.985）是颈动脉斑块易损性的独立危险因素。此外，Spearman 相关性分析显示，入院时 RLP-C、non-HDL-C/HDL-C、non-HDL-C、TG/HDL-C、CRI-I、CRI-II 和 AIP 的值与颈动脉斑块狭窄程度呈正相关（均 P<0.001）。
本研究表明，非传统脂质参数（RLP-C、non-HDL-C/HDL-C、non-HDL-C、CRI-I 和 CRI-II）可能是 AIS 患者颈动脉斑块易损性的潜在预测因子。然而，TG/HDL-C 和 AIP 之间未观察到显著相关性。RLP-C、non-HDL-C/HDL-C、non-HDL-C、TG/HDL-C、CRI-I、CRI-II 和 AIP 与颈动脉斑块狭窄程度密切相关。非传统脂质参数可作为颈动脉斑块易损性和狭窄的新型生物标志物。
