title: Low HDL-C level is associated with the development of intracranial artery stenosis: analysis from the Chinese IntraCranial AtheroSclerosis (CICAS) study.
abstract: BACKGROUND
  Intracranial atherosclerotic stenosis (ICAS) is an important cause of ischemic stroke worldwide. The role of high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C) in the development of ICAS remains to be elucidated. In the current study, we investigated the relationship of HDL-C level and the risk of developing ICAS in Chinese patients with acute ischemic stroke.
  
  
  METHODS
  From October 2007 to June 2009, a total of 1,984 consecutive ischemic stroke patients were evaluated for the presence of symptomatic ICAS by magnetic resonance angiography (MRA). Patients were classified into two groups: intracranial steno-occlusion (ICAS group, n = 888) and non-intracranial stenosis (NICAS group, n = 1096). Serum lipid profiles were analyzed and compared between the ICAS and NICAS group.
  
  
  RESULTS
  Significantly more patients in ICAS group had low HDL-C level (51.6%) than in the NICAS group (42.9%, P<0.001). The observed association remained significant after adjustment for conventional risk factors [(adjusted OR 1.36; 95%CI (1.13-1.63)]. Such predictive value of low level HDL-C persisted even when LDL-C was at very low level(<1.8 mmol/L). Patients in the lowest serum HDL-C quartile (<0.96 mmol/L) had the highest risk of developing ICAS [adjusted OR 1.52; 95%CI (1.17-1.98)] compared to patients in the highest serum HDL-C quartile (≥ 1.32 mmol/L) after adjustments for the covariates.
  
  
  CONCLUSIONS
  Low HDL-C level is strongly associated with the development of ICAS. There was an inverse relationship between the level of HDL-C and the risk of developing ICAS.
authors.affiliation: Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yining
authors.initials: Y
authors.lastname: Qian
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Pu
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.forename: David Z
authors.initials: DZ
authors.lastname: Wang
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.forename: Chunxue
authors.initials: C
authors.lastname: Wang
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.forename: Gaifen
authors.initials: G
authors.lastname: Liu
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000097:blood* / Q000453:epidemiology* / Q000473:pathology*
chemical_list: D008076:Cholesterol, HDL