A cross‐sectional study: Is there any effects of cholesterol ratios on acute ischemic stroke severity?

Abstract

Aim: The aim of prevention of stroke and stroke related complications is to control and eliminate modifiable risk factors. Since hypercholesterolemia is one of these risk factors, we aimed to compare the low density lipoprotein cholesterol (LDL-C) / high density lipoprotein cholesterol (HDL-C) and total cholesterol / HDL-C ratios with NIHSS scores and to evaluate the effects of these ratios on the severity of stroke.

Material and Methods:This retrospective cross-sectional study included 207 patients with ischemic stroke. Demographic characteristics, total cholesterol, triglycerides, LDL-C and HDL-C levels of patients who did not use any lipid-lowering drug and NIHSS scores were recorded in a data collection form.

The effects of LDL-C / HDL-C and total cholesterol / HDL-C ratios on NIHSS scores were investigated.
Results:The mean age of the patients was 69.3 years. The mean LDL-C / HDL-C ratio was 2.93 and the total cholesterol / HDL-C ratio was 4.68. The mean score of NIHSS was 7.05 at admission. No statistically significant difference or correlation was observed between all these parameters.

Conclusion:There was no statistically significant relationship between HDL-C / LDL-C and total cholesterol / HDL-C ratios and NIHSS scores. Considering the risk of ischemic stroke, prospective multicentric studies are needed to find proper parameters.

Keywords

• ischemic stroke,HDL-C,LDL-C

Kesitsel bir araştırma: Kolesterol oranlarının akut iskemik inme şiddeti üzerine etkisi var mı?

Abstract

Amaç:İnme ve inme ile ilgili komplikasyonların önlenmesinin amacı, değiştirilebilir risk faktörlerini kontrol etmek ve ortadan kaldırmaktır. Hiperkolesterolemi bu risk faktörlerinden biri olduğundan, düşük dansiteli lipoprotein kolesterol (LDL-C) / yüksek dansiteli lipoprotein kolesterol (HDL-C) ve total kolesterol / HDL-C oranları ile NIHSS puanlarını karşılaştırarak, bu oranların inme ciddiyetine etkilerini değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Bu retrospektif kesitsel araştırma iskemik inmeli 207 hastayı içermektedir. Hastaların demografik özellikleri, total kolesterol, trigliserit, herhangi bir lipid düşürücü ilaç kullanmayan hastaların LDL-C ve HDL-C düzeyleri ve NIHSS skorları bir veri toplama formunda kaydedildi. LDL-C / HDL-C ve total kolesterol / HDL-C oranlarının NIHSS puanlarına etkisi araştırıldı.

Bulgular:Hastaların yaş ortalaması 69.3 idi. Tüm bu hastalar arasında ortalama LDL-C / HDL-C oranı 2.93 ve total kolesterol / HDL-C oranı 4.68 idi. Başvuru sırasında NIHSS'nin ortalama puanı 7.05 idi. Tüm bu parametreler arasında istatistiksel olarak anlamlı bir fark veya korelasyon gözlenmedi.
Sonuç:Başvuru sırasında HDL-C / LDL-C ile total kolesterol / HDL-C oranları ve NIHSS skorları arasında istatistiksel olarak anlamlı bir ilişki gözlenmedi. İskemik inme risklerini göz önünde bulundurarak uygun parametreleri bulmak için ileriye dönük çok merkezli çalışmalara ihtiyaç vardır.

Keywords

• iskemik inme,HDL-C,LDL-C

References

1. 1. Katan M, Luft A. Global Burden of Stroke. Semin Neurol 2018; 38: 208-11
2. 2. Imamura T, Doi Y, Arima H et al. LDL cholesterol and the development of stroke subtypes and coronary heart disease in a general Japanese population: the Hisayama study. Stroke 2009; 40: 382-88.
3. 3. Kurth T, Everett BM, Buring JE, Kase CS, Ridker PM, Gaziano JM. Lipid levels and the risk of ischemic stroke in women. Neurology 2007; 68: 556-62.
4. 4. Tanne D, Yaari S, Goldbourt U. High-density lipoprotein cholesterol and risk of ischemic stroke mortality: a 21-year follow-up of 8586 men from the Israeli ischemic heart disease study. Stroke 1997; 28: 83-87.
5. 5. Sacco RL, Benson RT, Kargman DE et al. High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. J Am Med Assoc 2001; 285: 2729-35
6. 6. Amarenco P, Bogousslavsky J, Callahan 3rd A, Goldstein LB, Hennerici M, Rudolph AE, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med 2006; 355: 549-59
7. 7. Navab M, Ananthramaiah GM, Reddy ST et al. The oxidation hypothesis of atherogenesis: the role of oxidized phospholipids and HDL. J Lipid Res 2004; 45: 993-1007.
8. 8. Barter PJ, Nicholls S, Rye KA, Anantharamaiah GM, Navab M, Fogelman AM. Antiinflammatory properties of HDL. Circ Res 2004; 95: 764-72.

9. 9. Mineo C, Deguchi H, Griffin JH, Shaul PW. Endothelial and antithrombotic actions of HDL. Circ Res 2006; 98: 1352-64
10. 10. Jauch EC, Saver JL, Adams HP Jr et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2013; 44: 870–947.
11. 11. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bulletin of the World Health Organisation. 1976; 54: 541–53.
12. 12. Gotto AM, Assmann G, Carmena R. The ILIB lipid handbook for clinical practice: blood lipids and coronary heart disease. 2nd ed. New York, NY: International Lipid Information Bureau; 2000. p. 52, 53, 201.
13. 13. Genest J, Frohlich J, Fodor G, McPherson R; The Working Group on Hypercholesterolemia and Other Dyslipidemias. Recommendations for the management of dyslipidemia and the prevention of cardiovascular disease: 2003 update. CMAJ 2003; 169: 921–24
14. 14. Pintó X, Ros E. Lípidosséricos y prediccióndelriesgo cardiovascular: importancia de los cocientescolesterol total/colesterol HDL y cholesterol LDL/colesterol HDL. Clin Invest Arterioscl 2000; 12: 267–84
15. 15. Manninen V, Tenkanen L, Koskinen P et al. Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment. Circulation 1992; 85: 37–45
16. 16. Putaala J, Strbian D, Mustanoja S, Haapaniemi E, Kaste M, Tatlisumak T. Functional outcome in young adult ischemic stroke: impact of lipoproteins. Acta Neurol Scand 2013; 127: 61-69
17. 17. Sanossian N, Saver JL, Kim D, Razinia T, Ovbiagele B. Do high-density lipoprotein cholesterol levels influence stroke severity? J Stroke Cerebrovasc Dis 2006; 15: 187-89.
18. 18. Kuwashiro T, Sugimori H, Kamouchi M, Ago T, Kitazono T, Iida M. Lower levels of high-density lipoprotein cholesterol on admission and a recurrence of ischemic stroke: a 12-month follow-up of the Fukuoka Stroke Registry. J Stroke Cerebrovasc Dis 2012; 21: 561-68
19. 19. Makihara N, Okada Y, Koga M et al. Effect of serum lipid levels on stroke outcome after rt-PA therapy: SAMURAI rt-PA registry. Cerebrovasc Dis 2012; 33: 240-47
20. 20. Deng QW, Li S, Wang H et al. The Short-term Prognostic Value of the Triglyceride-to-high-density Lipoprotein Cholesterol Ratio in acute Ischemic Stroke. Aging Dis 2018; 9: 498-506.
21. 21. Qian Y, Pu Y, Liu L et al. Low HDL-C level is associated with the development of intracranial artery stenosis: analysis from the Chinese IntraCranial AtheroSclerosis (CICAS) study. PLoS One 2013; 8: 64395.