title: High levels of apolipoprotein B/AI ratio are associated with intracranial atherosclerotic stenosis.
abstract: OBJECTIVE
  The apolipoprotein B (apoB)/apoAI ratio is recognized as a better indicator of cardiovascular disease than other cholesterol measures. Whether intracranial or extracranial atherosclerosis is more closely associated with an increased apoB/apoAI ratio has not been investigated.
  
  
  METHODS
  A total of 464 statin or fibrate naïve Korean patients with acute ischemic stroke was categorized into 3 groups: intracranial (ICAS, n=236), extracranial (n=44), and no cerebral atherosclerotic stenosis (n=184). The apoB/apoAI ratio and demographics, including the presence of metabolic syndrome, were compared among the groups.
  
  
  RESULTS
  The ICAS group showed a higher apoB/apoAI ratio (0.81±0.02) than both the extracranial atherosclerotic stenosis (0.74±0.03) and no cerebral atherosclerotic stenosis (0.72±0.02) groups (P=0.002). The ratio was substantially increased (0.93±0.03) in patients with advanced ICAS (≥3 intracranial stenoses). With a multivariable analysis, the highest apoB/apoAI ratio quartile was an independent predictor of ICAS (OR, 2.13; 95% CI, 1.05 to 4.33). A dose-response relationship was observed between the presence of advanced ICAS and the apoB/apoAI ratio quartiles (OR, 4.03; 95% CI, 1.26 to 12.88 for the second quartile; OR, 4.88; 95% CI, 1.54 to 15.49 for the third quartile; and OR, 7.79; 95% CI, 2.41 to 25.16 for the fourth quartile when referenced to the first quartile). Patients having more metabolic syndrome components were more likely to have ICAS, advanced ICAS, and a higher apoB/apoAI ratio (P<0.001 for all).
  
  
  CONCLUSIONS
  A higher apoB/apoAI ratio is a predictor of ICAS rather than of extracranial atherosclerotic stenosis or no cerebral atherosclerotic stenosis. The apoB/apoAI ratio might be a biomarker for ICAS in Asian patients with stroke.
authors.affiliation: Stroke Center, Kwandong University Myongji Hospital, 697-24 Hwajeong-dong, Deokyang-gu Goyang, Gyeonggi-do 412-270, Korea. neurocraft@kd.ac.kr
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Keun-Sik
authors.initials: KS
authors.lastname: Hong
authors.forename: Eun-Ja
authors.initials: EJ
authors.lastname: Lee
authors.forename: Juneyoung
authors.initials: J
authors.lastname: Lee
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood*; D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000097:blood* / Q000175:diagnosis
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers