Abstract 14009: Serum NMR Metabolomics Identifies Similar Associations of Lipoproteins and Lipids With Risk of Myocardial Infarction and Ischemic Stroke but Not With Hemorrhagic Stroke

Abstract

Introduction: In observational studies, major circulating lipids (e.g. low density lipoprotein cholesterol) are associated with risk of myocardial infarction (MI) and ischemic stroke (IS), but their relationship with hemorrhagic stroke (HS) is not reliably established. An extensive panel of lipoprotein subclasses can be analysed by serum NMR metabolomics. Hypothesis: Circulating concentrations of lipoprotein particles and lipid constituents show similar patterns of association with risk of MI, IS and HS. Methods: The prospective China Kadoorie Biobank recruited 512,891 Chinese adults from 2004-08 with 7 years follow-up for incident events from registry and health insurance records. In a nested case-control study of 938 MI, 1276 IS and 1274 HS incident cases with 1355 controls, lipoprotein and lipid-related traits were quantified in baseline samples using serum NMR metabolomics. For each outcome, logistic regression yielded adjusted odds ratios (OR) associated with individual lipoprotein and lipid traits. Results: Concentrations of lipoprotein particles and their lipid components showed similar patterns of association with risk of MI and IS: risk increased with higher concentrations of very-low-, intermediate- and low-density lipoproteins (Figure). By contrast, for high density lipoproteins (HDL), increases in large particle concentration or lipid components were associated with reduced risk of both MI and IS, whereas medium HDL associated with reduced risk of MI but not IS. Small HDL showed null associations with MI and a trend towards increased risk of IS. No lipoprotein or lipid-related trait showed apparent associations with HS risk. Conclusions: Concentrations of lipoprotein particles and their lipid constituents show similar patterns of association with risk of MI/IS, whereas no associations were identified for HS. This suggests different etiologies and casts doubt on whether lipid-related traits play a major role in the etiology of HS.