Correlation between serum lipoprotein（a） level and carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke： a retrospective case series study

Abstract

Objective To investigate the risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke and the effect of serum lipoprotein（a） [ （Lp （a）] level on young and middle-aged patients with ischemic stroke. Methods Patients with ischemic stroke between the ages of 18 to 55 were enrolled. Carotid artery ultrasonography was used to evaluate the degree of carotid artery atherosclerosis, and the concentrations of serum total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B and Lp（a） were detected. According to the results of carotid ultrasound, the patients were divided into groups of without atherosclerosis, plaque without stenosis, and carotid artery stenosis. The demographic and clinical features were compared among the 3 groups. Multivariate logistic regression analysis was used to identify the independent risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke. Results A total of 106 patients with ischemic stroke （n =50 in the without atherosclerosis group, n =44 in the plaque without stenosis group, n = 12 in the carotid artery stenosis group） were enrolled in the study. The constituent ratios of age （45.98 ±7. 12, 50. 07 ±4. 79, and 50. 92 ± 1.83 years, respectively; F =7. 169, P =0. 001）, hypertension （26. 0%, 47. 7% and 58. 3%, respectively; X2 = 6. 862, P = 0. 032）, diabetes mellitus （22. 0%, 45. 5% and 66. 7%, respectively; X2 = 10. 729, P = 0. 005）, hyperlipidemia （24. 0%, 40. 1% and 75.0%, respectively; X2 = 11. 372, P =0. 003） and smoking （34. 0%, 61.4% and 75. 0%, respectively;x2 = 10. 93, P =0. 006）, as well as the serum high-density lipoprotein cholesterol （1.03 ± 0. 26, 0. 95 ± 0. 26 and 0. 76± 0. 08 mmol/L, respectively; F = 5. 882, P = 0. 004） and Lp （a） （0. 108 ± 0. 044, 0. 155± 0. 028 and 0. 200 ± 0. 011 g/L, respectively; F = 41. 556, P = 0. 000） levels had sigtificant differences in the 3 groups. Multivariate logistic reffession analysis showed that age 〉 48 years （plaques without stenosis： odds ratio [ OR ] 2. 89, 95% confidence interval [ CI] 1.20 - 6. 96, P = 0. 018; carotid artery stenosis： OR 4. 43, 95% CI 1.19 - 16. 57, P =0. 027）, hypertension （plaque without stenosis： OR 2. 60, 95 % C1 1.09 -6. 18, P =0. 031; carotid artery stenosis： OR 3.99, 95% CI 1.08 - 14. 77, P = 0. 039）, diabetes （plaque without stenosis： OR 2. 96, 95% CI 1.21 -7. 23, P=0. 018; carotid artery stenosis： OR 7. 09, 95% CI 1.79 -28. 02, P=0. 005）, hyperlipidemia （plaque without stenosis： OR 2. 19, 95% CI O. 91 - 5.31, P = 0. 082; carotid artery stenosis： OR 9.50, 95% CI 2. 21 -40. 86, P = 0. 002）, smoking （plaque without stenosis： OR 3.08, 95% CI 1.33 -7. 16, P = 0. 009; carotid artery stenosis： OR 5. 82, 95% CI 1.39 - 24. 38, P = 0. 016）, and Lp （a） （plaque without stenosis： OR 4. 38, 95% CI 1.76 - 10. 90, P = 0. 001; carotid artery stenosis： OR 12. 80, 95% CI 2. 73 - 52. 67, P =0. 001） were the independent risk factors for carotid artery atherosclerosis in young and middle-aged patients with ischemic stroke. Conclusions Age, smoking, hypertension, diabetes and Lp（a） were the independent risk factors for carotid artery atherosclerosis in young and middle-axt patients with ischemic stroke. Key words: Lipoprotein（a）; Arteriosclerosis; Stroke; Brain Ischemia; Biological Markers; Risk Factors