Abstract

Background: Intracranial arterial stenosis (ICAS) is a common cause of stroke. Identifying effective predictors of ICAS that could be easily obtained in clinical practice is important. The predictive values of serum individual lipid parameters have been well-established. In recent years, several non-traditional lipid parameters demonstrated greater predictive values for cardiovascular disease and ischemic stroke than traditional individual lipid parameters. However, their effects on asymptomatic ICAS (aICAS) are less clear. Therefore, we sought to observe the effects of non-traditional lipid parameters on aICAS.Methods: We enrolled 5,314 participants from the Asymptomatic Polyvascular Abnormalities in Community study. Asymptomatic ICAS was detected by transcranial Doppler ultrasonography (TCD). Non-traditional lipid parameters, including non-high-density lipoprotein cholesterol (non-HDL-C), the triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-C), atherogenic coefficient (AC), atherogenic index of plasma, and Castelli's risk index (CRI) were measured. We used multivariable logistic analysis to assess the association of different lipid parameters with aICAS; a trend test and subgroup analyses were also performed.Results: In total, 695 of 5,314 participants had aICAS in this study. For the comparison of the highest to the lowest tertile, the multivariable-adjusted odds ratios (ORs) (95% CIs) were 1.78 (1.39–2.27) (p trend < 0.001) for non-HDL-C, 1.48 (1.18–1.85) (p trend = 0.004) for the AC, 1.48 (1.18–1.85) (p trend = 0.004) for CRI-I, and 1.34 (1.09–1.66) (p trend = 0.032) for CRI-II. Subgroup analyses showed significant interactions between the AC, CRI-I, and diabetes.Conclusions: This large community-based study showed that non-HDL-C, AC, CRI-I, and CRI-II were significantly associated with increased prevalence of aICAS.

Highlights

  • Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, especially in Asian, Hispanic, and African populations [1]

  • Subgroup analyses showed significant interactions between the atherogenic coefficient (AC), Castelli’s risk index (CRI)-I, and diabetes. This large community-based study showed that non-HDL-C, AC, Castelli’s risk index-I (CRI-I), and Castelli’s risk index-II (CRI-II) were significantly associated with increased prevalence of asymptomatic ICAS (aICAS)

  • Among the 5,440 participants enrolled in the Asymptomatic Polyvascular Abnormalities in Community (APAC) study, 5,314 participants with complete information were enrolled in our cross-sectional analysis

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Summary

Introduction

Intracranial arterial stenosis (ICAS) is one of the most common causes of stroke, especially in Asian, Hispanic, and African populations [1]. ICAS contributes to the recurrence of stroke [4] In this regard, identifying and managing risk factors for asymptomatic ICAS (aICAS) in an early stage are crucial steps for slowing the progression and lowering the risk of further vascular events. Other lipid and lipoprotein biomarkers, such as total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), and triglycerides (TG), have been identified as risk factors for ischemic stroke over the past decades [6, 7]. Several non-traditional lipid parameters demonstrated greater predictive values for cardiovascular disease and ischemic stroke than traditional individual lipid parameters. Their effects on asymptomatic ICAS (aICAS) are less clear. We sought to observe the effects of non-traditional lipid parameters on aICAS

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