LDL phenotype B and other lipid abnormalities in patients with large vessel disease and small vessel disease.
OBJECTIVE
Controversies concerning the significance of lipid abnormalities in stroke come mostly from the researches that studied lipid profile without considering stroke aetiologies. We investigated the prevalence of LDL phenotype B and other lipid abnormalities in stroke survivors with large vessel disease (LVD) or small vessel disease (SVD) (TOAST criteria) and in control subjects (CS).


METHODS
We studied 30 patients with LVD and 41 patients with SVD screened out of 585 stroke patients and 30 CS who fulfilled the following exclusion criteria: cardiac disorders, renal or hepatic failure, diabetes mellitus, or treatment with lipid-lowering agents. At least 3 months after stroke, the concentrations of total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TGs), apolipoprotein E (apoE), and lipoprotein (a) [lp(a)] were measured and LDL phenotypes and apoE isoforms were identified.


RESULTS
Patients with LVD had significantly higher concentrations of LDL-C than CS (p<0.05). They had higher concentrations of TGs and lower concentrations of HDL-C than patients with SVD and CS (p<0.05). LDL phenotype B was more frequent in patients with LVD (63.3%) than in patients with SVD (39.0%) or in CS (16.7%) (p<0.05). The concentration of apoE was higher in patients with LVD than in patients with SVD or in CS (p<0.05). The percentage of patients with increased level of lp(a) (i.e., >30 mg/ml) was greater in patients with LVD (36.7%) than in CS (10%) (p<0.05).


CONCLUSIONS
Patients with stroke due to LVD, but not SVD, have high prevalence of atherogenic lipid abnormalities, including increased frequency of LDL phenotype B and higher percentage of increased lp(a) level, like patients with other atherogenic diseases.
Slowik
Agnieszka
A
Department of Neurology, Jagiellonian University College of Medicine, Ul. Botaniczna 3, Cracow 31-503, Poland. slowik@neuro.cm-uj.krakow.pl
Iskra
Tomasz
T
Turaj
Wojciech
W
Hartwich
Jadwiga
J
Dembinska-Kiec
Aldona
A
Szczudlik
Andrzej
A
D000368:Aged; D001057:Apolipoproteins E / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood* / Q000235:genetics; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D014280:Triglycerides / Q000097:blood
D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D014280:Triglycerides; D002784:Cholesterol