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Stroke:非传统血脂指标亦是引发中风的关键因素

  1. 中风
  2. 血脂指标

来源:生物谷 2012-11-18 10:54

以往认为低密度脂蛋白(LDL)是增加心脏病发病风险的一大关键因素,而最近发表在Stroke杂志的一研究证实:一些我们平时不太关注的血脂指标也与中风的发病密切相关,并且这些指标致病危险程度有可能都超过了LDL。 研究人员共设正常对照组和病例组两组,共有774名美国中老年妇女被安排在病例组,这些女性在近八年时间内均罹患过中风疾病。

以往认为低密度脂蛋白(LDL)是增加心脏病发病风险的一大关键因素,而最近发表在Stroke杂志的一研究证实:一些我们平时不太关注的血脂指标也与中风的发病密切相关,并且这些指标致病危险程度有可能都超过了LDL。

研究人员共设正常对照组和病例组两组,共有774名美国中老年妇女被安排在病例组,这些女性在近八年时间内均罹患过中风疾病。同时在正常对照组也有774名美国中老年妇女参与,这些人于病例组的妇女在种族上保持一致,年龄上也相差不大。

结果未发现LDL与中风发病风险之间又相关性,而甘油三酯的水平却与中风发病有着密切关系。在排除了高血压、糖尿病等中风相关诱发因素后,那些甘油三酯水平最高的女性比甘油三酯水平最低的妇女在罹患中风风险上高出了56%。

该研究还关注了其他一些与中风发病相关的血脂指标包括中密度脂蛋白(IDL)以及极低密度脂蛋白(VLDL)等。IDL血中含量最少的女性比含量最多的女性在发生中风的风险上高出了46%,血中VLDL颗粒最大的女性罹患中风的风险也较颗粒较小的女性要高。

虽然近几年来已有一些相关研究提示一些非传统的血脂指标对中风也可能具有重要的作用,但关于这一观点的研究仍不是很多。除了总胆固醇、LDL等传统指标外,一些非传统的指标对于中度风险患者也会有帮助的。但迄今还没有相关研究能证实降低这些非传统指标能降低中风患者死亡率或是降低中风的发病率。(生物谷Bioon.com)

Lipid and Lipoprotein Biomarkers and the Risk of Ischemic Stroke in Postmenopausal Women

Jeffrey S. Berger, MD, MS; Aileen P. McGinn, PhD; Barbara V. Howard, PhD; Lewis Kuller, MD, DrPH; JoAnn E. Manson, MD, DrPH; Jim Otvos, PhD; J. David Curb, MD; Charles B. Eaton,MD; Robert C. Kaplan, PhD; John K. Lynch,et al.

Background—Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial.

Methods—We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio.

Results—In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13–2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10–2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04–2.04; P for trend=0.02) were significantly associated with ischemic stroke.

Conclusions—Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women.

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