Zhang Peng, Zhang Ziheng, Li Daojing, Han Rongrong, Li Hongfang, Ma Jinfeng, Xu Peng, Qi Ziyou, Liu Lixia, Zhang Aimei
Clinical Medical College, Jining Medical University, Jining, China.
Department of Neurology, the Affiliated Hospital of Jining Medical University, Jining, China.
J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107293. doi: 10.1016/j.jstrokecerebrovasdis.2023.107293. Epub 2023 Aug 19.
To evaluate the association between remnant cholesterol (remnant-C) and intracranial atherosclerotic disease (ICAD) in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS).
We studied 1,564 participants with data on lipid profiles and high-resolution vessel wall MRI (VWMRI) from the ARIC-NCS. Remnant-C was computed as total cholesterol minus high-density lipoprotein cholesterol minus low-density lipoprotein cholesterol (LDL-C). The primary outcomes were the presence of intracranial plaques and luminal stenosis. Contributors were separated into four different groups based on remnant-C (22 mg/dL) and LDL-C (100 mg/dL) levels to investigate the function of remnant-C vs. LDL-C on ICAD. Multivariable logistic regression models were utilized to estimate the correlation among the discordant/concordant remnant-C and LDL-C, and ICAD.
A total of 1,564 participants were included (age 76.2 ± 5.3). After multivariable adjustment, log remnant-C was correlated with greater ICAD risk [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.01 to 1.83]. The lower remnant-C/higher LDL-C group and the higher remnant-C/lower LDL-C group manifested a 1.53-fold (95% CI 1.06 to 2.20) and 1.52-fold (95% CI 1.08 to 2.14) greater risk of ICAD, relative to those having lower remnant-C/low LDL-C. Additionally, remnant-C ≥ 22 mg/dL distinguished participants at a greater risk of the presence of any stenosis compared to those at lower levels, even in participants with optimal levels of LDL-C.
Elevated levels of remnant-C were connected to ICAD independent of LDL-C and traditional risk factors. The mechanisms of remnant-C association with ICAD probably offer insight into preventive risk-factor of ischemic stroke.
在社区动脉粥样硬化风险神经认知研究（ARIC-NCS）中评估残余胆固醇（remnant-C）与颅内动脉粥样硬化疾病（ICAD）之间的关联。
我们研究了ARIC-NCS中1564名有血脂谱和高分辨率血管壁磁共振成像（VWMRI）数据的参与者。残余胆固醇（remnant-C）的计算方法为总胆固醇减去高密度脂蛋白胆固醇再减去低密度脂蛋白胆固醇（LDL-C）。主要结局为颅内斑块和管腔狭窄的存在情况。根据残余胆固醇（remnant-C）（22mg/dL）和低密度脂蛋白胆固醇（LDL-C）（100mg/dL）水平将参与者分为四个不同组，以研究残余胆固醇（remnant-C）与低密度脂蛋白胆固醇（LDL-C）对ICAD的作用。使用多变量逻辑回归模型来估计不一致/一致的残余胆固醇（remnant-C）和低密度脂蛋白胆固醇（LDL-C）与ICAD之间的相关性。
共纳入1564名参与者（年龄76.2±5.3）。经过多变量调整后，log残余胆固醇（remnant-C）与更高的ICAD风险相关[比值比（OR）为1.36，95%置信区间（CI）为1.01至1.83]。与残余胆固醇（remnant-C）较低/低密度脂蛋白胆固醇（LDL-C）较低的参与者相比，残余胆固醇（remnant-C）较低/低密度脂蛋白胆固醇（LDL-C）较高组和残余胆固醇（remnant-C）较高/低密度脂蛋白胆固醇（LDL-C）较低组患ICAD的风险分别高1.53倍（95%CI为1.06至2.20）和1.52倍（95%CI为1.08至2.14）。此外，即使在低密度脂蛋白胆固醇（LDL-C）水平最佳的参与者中，残余胆固醇（remnant-C）≥22mg/dL的参与者存在任何狭窄的风险也更高。
残余胆固醇（remnant-C）水平升高与ICAD相关，且独立于低密度脂蛋白胆固醇（LDL-C）和传统危险因素。残余胆固醇（remnant-C）与ICAD关联的机制可能为缺血性中风的预防性危险因素提供见解。
