Abstract

Background: Triglyceride (TG)/high-density lipoprotein cholesterol ratio (THR) is a marker of dyslipidemia, and high THR is associated with an increase in cardiovascular events. In the present study, whether THR was associated with various markers of cerebral vascular pathologies, atherosclerosis of major cerebral arteries, including large artery atherosclerosis (LAA) and cerebral small vessel disease (SVD), in neurologically healthy individuals was investigated.Methods: Vascular risk factors, brain magnetic resonance imaging (MRI) scans, and MR angiograms of 851 study subjects were evaluated. Findings of extracranial atherosclerosis (ECAS) and intracranial atherosclerosis (ICAS) were considered indices of LAA based on brain MR angiograms. The presence of silent lacunar infarct (SLI) and white matter hyperintensities (WMHs) were evaluated as indices of SVD based on brain MRIs.Results: Subjects with ICAS (odds ratio, 1.83; 95% confidence interval, 1.06–3.16; P = 0.03) were significantly more likely to have high THR tertile (THR > 2.06) than low THR tertile (THR < 1.37) after adjusting for cardiovascular risk factors. THR was higher in subjects with multiple ICAS lesions than in those with single ECAS or without ICAS lesions. Associations among THR tertiles in ECAS, SLI, and WMHs were not significant.Conclusion: In the present study, a positive association between high THR and the development of ICAS was observed in neurologically healthy participants.

Highlights

  • Modification of vascular risk factors is important for future stroke prevention

  • small vessel disease (SVD) share common risk factors with large artery atherosclerosis (LAA), the pathogenesis is distinct from LAA [7]. These findings indicate novel factors besides classical vascular risk factors for ischemic stroke may be involved in the distinct break cerebrovascular pathology

  • The prevalence of intracranial atherosclerosis (ICAS) was significantly higher in the high TG and HDLC level ratio (THR) group (T3) than in the low THR tertile group (T1) (OR, 1.83; 95% confidence interval (CI), 1.06–3.16; P = 0.03)

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Summary

Introduction

Modification of vascular risk factors is important for future stroke prevention. Ischemic stroke is caused by heterogeneous vascular pathologies in the brain [1]. Atherosclerosis of major cerebral arteries is one of the strongest risk factors for ischemic stroke. The large artery atherosclerosis (LAA) is divided into extracranial atherosclerosis (ECAS) and intracranial atherosclerosis (ICAS) based on the anatomical site of atherosclerosis. Triglyceride (TG)/high-density lipoprotein cholesterol ratio (THR) is a marker of dyslipidemia, and high THR is associated with an increase in cardiovascular events. Whether THR was associated with various markers of cerebral vascular pathologies, atherosclerosis of major cerebral arteries, including large artery atherosclerosis (LAA) and cerebral small vessel disease (SVD), in neurologically healthy individuals was investigated

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