Department of Neurology, Beijing Tiantan Hospital.
China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders.
Neurologist. 2023 Sep 1;28(5):300-303. doi: 10.1097/NRL.0000000000000488.
It is unknown whether plasma low-density lipoprotein-cholesterol level (LDL-C) can predict the occurrence of intracranial atherosclerotic stenosis (ICAS), especially asymptomatic (A)ICAS. This study investigated whether LDL-C level is independently associated with AICAS.
The Asymptomatic Polyvascular Abnormalities Community study is an ongoing community-based, prospective, long-term follow-up observational study with 3387 participants. AICAS was diagnosed by transcranial Doppler ultrasonography. The participants were divided into 3 groups based on LDL-C level. Cox regression was used to evaluate the association between LDL-C level and incidence of AICAS.
During 2 years of follow-up, 9.98% of participants were diagnosed with AICAS. The incidence of AICAS (person-years with 95% CI) was 4.99% (4.48%-5.50%). AICAS incidence did not increase with increasing LDL-C level. Compared with the <2.6 mmol/l subgroup, the incidence of asymptomatic ICAS was not significantly higher in the 2.6 to 3.4 and >3.4 mmol/l subgroups after adjusting for confounding factors (hazard ratio=0.95, 95% CI: 0.86-1.03 and hazard ratio=0.96, 95% CI: 0.84-1.10, respectively).
LDL-C is not an independent predictor of AICAS incidence in the Chinese population.
目前尚不清楚血浆低密度脂蛋白胆固醇(LDL-C)水平是否可以预测颅内动脉粥样硬化性狭窄(ICAS)的发生,尤其是无症状性(A)ICAS。本研究旨在探讨 LDL-C 水平是否与 AICAS 的发生存在独立相关性。
无症状性多血管异常社区研究(Asymptomatic Polyvascular Abnormalities Community study)是一项正在进行的基于社区的、前瞻性、长期随访观察性研究,共纳入 3387 名参与者。通过经颅多普勒超声检查诊断 AICAS。根据 LDL-C 水平将参与者分为 3 组。采用 Cox 回归评估 LDL-C 水平与 AICAS 发生率之间的关系。
在 2 年的随访期间,有 9.98%的参与者被诊断为 AICAS。AICAS 的发生率(人年及 95%可信区间)为 4.99%(4.48%-5.50%)。随着 LDL-C 水平的升高,AICAS 的发生率并未增加。在校正混杂因素后,与<2.6mmol/l 亚组相比,2.6-3.4mmol/l 和>3.4mmol/l 亚组的无症状性 ICAS 发生率并无显著升高(风险比=0.95,95%可信区间:0.86-1.03 和风险比=0.96,95%可信区间:0.84-1.10)。
在中国人群中,LDL-C 不是 AICAS 发生率的独立预测因子。