Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack

Abstract

Aim: Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is defined as the serum atherogenicity index. High TG/HDL-C ratio is related with vascular diseases, insulin resistance and metabolic syndrome. The TG/HDL-C ratio in cerebrovascular diseases, especially in silent cerebral lesions hasn’t been well studied. The aim of this study was to evaluate the frequency of silent cerebral ischemia (SCI) and leukoaraiosis (LA), and its relationship with TG/HDL-C ratio in patients admitted with the first ischemic stroke attack. Material and Methods: We retrospectively evaluated 200 patients who admitted to Bulent Ecevit University Faculty of Medicine, Department of Neurology with the diagnosis of acute first ischemic stroke. Silent cerebral lesions were defined as LA and SCI with magnetic resonance imaging. TG/HDL-C ratio was calculated by dividing TG levels by HDL-C levels. Results: Silent cerebral lesions were detected 124 (83.2%) of 149 patients. LA severity was evaluated according to Fazekas score, 22 (14.8%) of patients were grade 0, 49 (32.9%) of them were grade 1, and 78 (52.3%) of them were advanced periventricular white matter hyperintensity (adv-PWMH) group. TG/HDL-C ratio in SCI group was higher than the group without SCI, but it wasn’t statistically significant (p=0.091). A significant increase was observed in the TG/HDL-C ratio, as LA severity increased. TG/HDL-C ratio was significantly higher in adv-PWMH group (p=0.050). Conclusion: High serum atherogenicity index is associated with atherosclerosis and vascular endothelial dysfunction. With this simple, inexpensive and effective test method, high-risk group of LA and SCI could be identified.

Keywords

• Silent cerebral ischemia
• leukoaraiosis
• TG/HDL-C ratio
• serum atherogenic index

İlk İnme Atağı Olan Olgularda Sessiz Serebral Lezyonların Trigliserid/HDL-Kolesterol Oranı ile İlişkisinin Değerlendirilmesi

Abstract

Amaç: Trigliserid/yüksek yoğunluklu lipoprotein kolesterol (TG/HDL-K) oranı serum aterojenite indeksi olarak tanımlanmıştır. Yüksek TG/HDL-K oranı vasküler hastalıklar, insülin direnci ve metabolik sendrom ile ilişkilidir. Serebrovasküler olaylarda özellikle sessiz serebral lezyonlarda TG/HDL-K oranı ile ilgili çalışmalar azdır. Bu çalışmanın amacı, ilk iskemik inme atağı ile başvuran hastalarda sessiz serebral iskemi (SSİ) ve lökoariozis (LA) sıklığını ve TG/HDL-K oranı ile ilişkisini değerlendirmektir. Gereç ve Yöntemler: Bülent Ecevit Üniversitesi Tıp Fakültesi Nöroloji bölümüne akut ilk iskemik inme tanısı ile başvuran 200 hasta geriye dönük olarak değerlendirildi. Manyetik rezonans görüntüleme ile sessiz serebral lezyonlar SSİ ve LA olarak tanımlandı. TG/HDL-K oranı TG değerinin HDL-K değerine bölünmesi ile hesaplandı. Bulgular: Yüz kırk dokuz hastanın 124 (%83,2)’ünde sessiz serebral lezyon saptandı. LA şiddeti Fazekas skorlamasına göre değerlendirildi, hastaların 22 (%14,8)’si grade 0, 49 (%32,9)’u grade 1 ve 78 (%52,3)’i ileri düzey periventriküler beyaz cevher lezyonu (advanced periventricular white matter hyperintensity, adv-PWMH) grubundaydı. SSİ grubunda TG/HDL-K oranı SSİ olmayan gruba göre daha yüksek bulundu, ancak istatistiksel olarak anlamlı değildi (p=0,091). LA şiddeti arttıkça TG/HDL-K oranında anlamlı bir artış olduğu izlendi. TG/HDL-K oranı, adv-PWMH grubunda anlamlı derecede yüksek idi (p=0,050). Sonuç: Yüksek serum aterojenite indeksi ateroskleroz ve vasküler endotelyal disfonksiyon ile ilişkilidir. Bu basit, ucuz ve etkili test yöntemi ile LA ve SSİ yüksek risk grubu belirlenebilir.

Keywords

• Sessiz serebral iskemi
• lökoariozis
• TG/HDL-K oranı
• serum aterojenite indeksi

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