Correlation between apolipoprotein B/apolipoprotein A-I and intracranial artery stenosis in young patients with ischemic stroke

Abstract

Objective To investigate the relationship between the serum apolipoprotein B (ApoB)/ApoA-Ⅰ ratio and intracranial artery stenosis in young patients with ischemic stroke. Methods Patients with ischemic stroke aged from 18 to 45 were enrolled in the study. Brain CT angiography was used to evaluate the degree of intracranial artery stenosis, and the concentrations of serum total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, ApoA-Ⅰ, and ApoB were detected. The ratio of ApoB/ApoA-Ⅰwas calculated. The Demographic and clinical characteristics of the intracranial artery stenosis group and the non-intracranial artery stenosis group were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for intracranial artery stenosis in young patients with ischemic stroke. Results A total of 161 young patients with ischemic stroke were enrolled, including 89 in the intracranial artery stenosis group and 72 in the non-intracranial artery stenosis group. The constituent ratios of diabetes mellitus (20.2% vs. 6.9%; χ2=4.641, P=0.032), smoking (47.5% vs. 15.2%; χ2=15.121, P=0.001), hyperlipidermia (56.1% vs. 48.6%; χ2=4.197, P=0.040), as well as the radios in serum high-density lipoprotein cholesterol (1.29±0.30 mmol/L vs. 1.65±0.34 mmol/L; t=7.131, P=0.002), ApoA-Ⅰ (1.49±0.65 g/L vs. 1.63±0.23 g/L; t=2.751, P=0.001), ApoB (1.49±0.65 g/L vs. 1.63±0.23 g/L; t=2.751, P=0.001), and ApoB/ApoA-Ⅰratio (1.49±0.65 vs. 1.63±0.23; t=2.751, P=0.001) had significant differences between the two groups. Multivariate logistic regression analysis showed that diabetes (odds ratio [OR] 3.052, 95% confidence interval [CI] 1.186-7.856; P=0.021), smoking (OR 2.997, 95% CI 1.456-6.172; P=0.003), hyperlipidemia (OR 4.745, 95% CI 2.108-10.668; P=0.001), ApoB (OR 4.861, 95% CI 3.029-7.802; P=0.001), and ApoB/ApoA-Ⅰ ratio (OR 5.684, 95% CI 2.215-14.584; P=0.002) were the independent risk factors for intracranial artery stenosis in young patients with ischemic stroke, while HDL-C (OR 0.561, 95% CI 0.354-0.888; P=0.014) and ApoA-Ⅰ (OR 0.065, 95% CI 0.010-0.409; P=0.004) were the independent protective factors. After adjustment for hypertension, diabetes, smoking, hyperlipidemia, HDL-C, ApoA-Ⅰ, and ApoB, ApoB/ApoA-Ⅰ ratio was still an independent risk factor for intracranial artery stenosis in young patients with ischemic stroke (each increase of 1 standard deviation, OR 4.255, 95% CI 2.348-7.711; P=0.001). Conclusion ApoB/ApoA-Ⅰratio is an independent risk factor for intracranial artery stenosis in young patients with ischemic stroke. Key words: Stroke; Brain Ischemia; Intracranial Arteriosclerosis; Apolipoproteins B; Apolipoprotein A-Ⅰ; Risk Factors