İskemik inmede koruyucu olan HDL hemorajik inme için tetikliyici mi?

Yıl 2021, Cilt: 4 Sayı: 2, 83 - 91, 01.07.2021

Zeynep Baştuğ Gül , Figen Varlıbaş

Öz

Giriş ve Amaç: Lipitler endotel hücre membran yapısında önemli rol oynar. Hiperlipidemi özelikle iskemik inme için bilinen bir risk faktörüdür. Bu çalışmada lipit parametrelerinin (özellikle HDL) hemorajik inmedeki etkisini belirlemek üzere iskemik inmeli hastalar ile karşılaştırıldı.

Gereç ve Yöntem: Çalışmamızda Nöroloji kliniğinde serebrovasküler hastalık tanısıyla yatan 1500 hasta tarandı. Dışlanma kriterleri sonucunda, 148 hemorajik inmeli ve 152 iskemik inme hastası alındı. Hastaların risk faktörleri ve lipit parametreleri bilgileri dosyalarından retrospektif olarak tarandı. Hastaların 12 saatlik açlık sonrası lipit parametreleri incelendi. Hastaların hastane içi ölümleri kaydedildi.
Bulgular: Hemorajik grupta HDL değerleri daha yüksek, trigliserit ve VLDL değerleri ise düşük saptandı (p<0,001). Çoklu regrasyon analizinde hemorajik inme için bağımsız risk faktörü olarak HDL saptandı (p<0,001). Hemorajik inme ile HDL arasında pozitif korelasyon, hemorajik inme ile VLDL ve trigliserit arasında negatif korelasyon izlendi. Hastane içi ölümü öngören bağımsız değişkenler, hemorajik inme ve yaşın 72 den yüksek olmasıdır.

Sonuç: Bu çalışmada hemorajik inme için bağımsız risk faktörü olarak HDL saptandı. Lipitler hücre membranların yapısında önemli rol oynar. HDL aracılı ters kolesterol taşınması olayında damar endotelindeki kolesterol karaciğere taşınır, bunun sonucunda beyin damar endotelindeki hücrelerinin yapısının etkilediği düşünülmektedir. Düşük trigliserit seviyeleriyle birlikte damar endoteli daha da zayıflar. Sonuç olarak, özellikle yüksek HDL düzeyleri ile birlikte düşük trigliserit seviyeleri hemorajik inme etiyolojisinde rol oynayabilir.

Anahtar Kelimeler

HDL, Hemorajik inme, Triglisrit, İskemik inme

HDL Cholesterol Being Protective Against Ischemic Stroke, Is It Triggering For Hemorrhagic Stroke?

Öz

Introduction: Lipids play an important role in endothelial cell membrane structure. Hyperlipidemia is a known risk factor, especially for ischemic stroke. We compared patients with ischemic stroke to determine the effect of lipid parameters (especially HDL) in hemorrhagic stroke.

Methods: In our study, 1500 patients with a diagnosis of cerebrovascular disease were scanned in the Neurology clinic. As a result of exclusion criteria, 148 hemorrhagic stroke and 152 ischemic stroke patients were included. The risk factors and lipid parameters of the patients were retrospectively reviewed from their files. Lipid parameters of the patients were evaluated after 12 hours of fasting.
Results: HDL values were higher and triglyceride and VLDL values were lower in the hemorrhagic group (p<0.001). In multiple regression analysis, HDL was determined as an independent risk factor for hemorrhagic stroke (p<0.001). There was positive correlation between hemorrhagic stroke and HDL, and negative correlation between hemorrhagic stroke and VLDL and triglyceride. Independent variables predicting in-hospital death are hemorrhagic stroke and age higher than 72.

Conclusion: In this study, HDL was determined as an independent risk factor for hemorrhagic stroke. Lipids play an important role in the structure of cell membranes. In the case of HDL-mediated reverse cholesterol transport, cholesterol in the vascular endothelium is transported to the liver, as a result, it is thought to affect the structure of cells in the brain vessel endothelium. With low triglyceride levels, the vascular endothelium becomes even weaker. As a result, low triglyceride levels, especially with high HDL levels, may play a role in the etiology of hemorrhagic stroke.

Anahtar Kelimeler

HDL, Hemorrhagic stroke, Triglyceride, Ischemic stroke

Kaynakça

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