Rajan Thulasi, M Ganesh, K Sowmya, L Easwar
Biochemistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Radiodiagnosis, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Jul 24;16(7):e65292. doi: 10.7759/cureus.65292. eCollection 2024 Jul.
Cerebrovascular accident (CVA), also commonly known as stroke, is an acute condition characterized by jeopardized perfusion of the brain tissue. Atherosclerosis is a common converging point for the various risk factors for CVA. It is a chronic, evolving condition of the vessel wall characterized by peculiar lesions known as atheromas. Low-density lipoprotein cholesterol (LDL-C) has been one of the established and traditional risk factors for the development of plaques in atherosclerosis. Small dense LDL-C (sdLDL-C) is a subclass of LDL-C that is considered more atherogenic, and its role in atherosclerotic plaque formation has been very well established. Hence, in this study, we aimed to find the association between calculated sdLDL-C and atherosclerotic carotid plaque (including various plaque characteristics).
This retrospective cross-sectional study was conducted at Sri Ramachandra Medical College and Research Institute between December 2022 and December 2023 after getting ethics approval from the Institutional Ethics Committee. Patients who underwent CT angiogram (312) were included in the study, and their lipid profile data were collected from the Laboratory Information System. Participants were divided into groups depending on the presence or absence of carotid plaque, the characteristics of the plaque, and the narrowing caused by the plaque. sdLDL-C was calculated using Sampson formula from the lipid parameters in these groups. Statistical analysis was done using SPSS Statistics version 16.0 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). A p-value of <0.05 was considered significant.
sdLDL-C was significantly higher in the plaque group (37.25 ± 13.69 mg/dL) when compared to the group without plaques on CT angiogram (34.09 ± 11.64 mg/dL) (p<0.05), wherein the LDL-C wasn't significantly different between the two groups. sdLDL-C was also elevated in the soft plaque sub-group (39.46 ± 13.63 mg/dL) when compared to the calcific plaque sub-group (35.41 ± 13.05 mg/dL), which was statistically significant (p<0.05).
sdLDL-C is associated with atherosclerotic carotid plaques, especially the soft plaques on CT angiogram, which are considered to be vulnerable plaques. Thus, calculated sdLDL-C can be utilized as a cost-effective tool to assess plaque vulnerability and monitor hypolipidemic treatment in addition to LDL-C.
脑血管意外（CVA），也通常被称为中风，是一种以脑组织灌注受损为特征的急性病症。动脉粥样硬化是CVA各种危险因素的一个常见汇聚点。它是一种血管壁的慢性、渐进性病症，其特征是存在被称为动脉粥样瘤的特殊病变。低密度脂蛋白胆固醇（LDL-C）一直是动脉粥样硬化斑块形成的既定传统危险因素之一。小而密低密度脂蛋白胆固醇（sdLDL-C）是LDL-C的一个亚类，被认为更具致动脉粥样硬化性，并且其在动脉粥样硬化斑块形成中的作用已得到充分证实。因此，在本研究中，我们旨在寻找计算得出的sdLDL-C与动脉粥样硬化性颈动脉斑块（包括各种斑块特征）之间的关联。
这项回顾性横断面研究于2022年12月至2023年12月在斯里兰卡拉马钱德拉医学院和研究所进行，此前已获得机构伦理委员会的伦理批准。纳入了接受CT血管造影的患者（312例），并从实验室信息系统收集了他们的血脂谱数据。根据是否存在颈动脉斑块、斑块特征以及斑块导致的狭窄情况将参与者分组。使用桑普森公式根据这些组中的血脂参数计算sdLDL-C。使用SPSS Statistics 16.0版（SPSS公司。2007年发布。适用于Windows的SPSS，版本16.0。芝加哥，SPSS公司）进行统计分析。p值<0.05被认为具有统计学意义。
与CT血管造影显示无斑块的组（34.09±11.64mg/dL）相比，斑块组的sdLDL-C显著更高（37.25±(13.69mg/dL)）（(p<0.05)），而两组之间的LDL-C无显著差异。与钙化斑块亚组（35.41±13.05mg/dL）相比，软斑块亚组的sdLDL-C也升高（39.46±13.63mg/dL），具有统计学意义（(p<0.05)）。
sdLDL-C与动脉粥样硬化性颈动脉斑块相关，尤其是CT血管造影上的软斑块，这些软斑块被认为是易损斑块。因此，除了LDL-C之外，计算得出的sdLDL-C可作为一种经济有效的工具来评估斑块易损性并监测降脂治疗。
