Abstract
Background and Purpose: Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical or subclinical ischemic events, while the relationship between low-density lipoprotein cholesterol (LDL-C) measured at a single time point and intracranial atherosclerotic stenosis (ICAS) is inconsistent. This study aims to assess the association between cumulative exposure to increased LDL-C and the prevalence of asymptomatic ICAS.Methods: The Asymptomatic Polyvascular Abnormalities Community study was investigated on the epidemiology of asymptomatic polyvascular abnormalities in Chinese adults. In this study, we included 4,523 participants with LDL-C measured at 3 examinations in 2006, 2008, and 2010. Cumulative exposure to increased LDL-C was calculated as following: LDL-C burden2006−2008 = [(LDL-C2006-1.8) + (LDL-C2008-1.8)]/2 * time2006−2008; LDL-C burden = LDL-C burden2006−2008 + LDL-C burden2008−2010. Transcranial doppler ultrasonography was performed in 2010 to detecting the ICAS.Results: Of the 4,347 patients, 13.3% (580/4,347) were diagnosed with ICAS. In univariate analysis, the association between LDL-C burden and ICAS prevalence was significant, the odds ratios (95% confidence interval) from the lowest to the highest quartile were 1 (reference), 1.30 (0.99–1.70), 1.32 (1.01–1.73), and 2.14 (1.66–2.75), respectively (P < 0.05). After adjustment for potential confounding factors, the same result was reached.Conclusions: Cumulative exposure to increased LDL-C is concentration-dependently associated with increased prevalence of asymptomatic ICAS, especially in those under the age of 65 y or free of hypertension, diabetes mellitus, and hyperlipidemia.
Highlights
Stroke has become the most common and disabling disease in China, and ischemic stroke is the primary type [1, 2]
Of the 4,347 participants, 580 (13.3%) of them were detected as having asymptomatic intracranial atherosclerotic stenosis (ICAS) based on the Transcranial doppler ultrasonography (TCD) results
When comparing the baseline characteristics according to quartile of low-density lipoprotein cholesterol (LDL-C) burden, there were significant differences in age, sex, Body mass index (BMI), physical activity, income status, hypertension, hyperlipidemia, smoking, drinking, systolic and diastolic blood pressure, FBG, and UA
Summary
Stroke has become the most common and disabling disease in China, and ischemic stroke is the primary type [1, 2]. Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical, subclinical ischemic events, and its association with cognitive deficits, especially in non-whites [3, 4]. Some studies have shown that hyperlipidemia, especially increased low-density lipoprotein cholesterol (LDL-C), is an independent risk factor for atherosclerotic stenosis and vulnerable plaque of ECAS [7,8,9]. Some studies suggested that higher LDL-C levels might be associated with increased risk of ICAS [14]. Intracranial atherosclerosis has gained increasing attention due to the high risk of recurrent clinical or subclinical ischemic events, while the relationship between low-density lipoprotein cholesterol (LDL-C) measured at a single time point and intracranial atherosclerotic stenosis (ICAS) is inconsistent.
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