Abstract
BackgroundThis study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population.MethodsThis cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated.ResultsThe TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios (all P < 0.05) were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analysis revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for the identification of ICAS.ConclusionThe TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients.
Highlights
This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population
Take home message Lipid ratios could be more valuable than lipid levels alone for predicting ICAS risk, and sex-based differences were examined regarding the predictive accuracy of lipid profiles
The patients were divided into four subgroups as follows: No cerebral atherosclerotic stenosis (NCAS) (55.6%), Isolated ICAS (27.7%), Isolated extracranial atherosclerotic stenosis (ECAS) (7.0%), and ICAS combined with ECAS (9.7%)
Summary
This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population. Intracranial atherosclerotic stenosis (ICAS) is a major cause of ischemic stroke worldwide [1, 2]. The prevalence of ICAS is relatively high in Asians, whereas extracranial atherosclerotic stenosis (ECAS) is more common in Caucasians. The exact causes for this distribution of cerebral atherosclerosis are not clear, but racial differences, socioeconomic status, and risk factors may contribute to this phenomenon [3]. Because of the detrimental effects of ICAS, a better understanding of its risk factors is important. The role of lipid parameters and lipid ratios in ICAS is controversial.
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