title: Association between Hypertriglyceridemia and Lacunar Infarction in Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Although recent studies have shown that the elevation of serum triglyceride (TG) is related to the increased incidence of ischemic stroke, the relationship between hypertriglyceridemia and subtypes of ischemic stroke is largely unknown. This study attempted to evaluate whether hypertriglyceridemia is associated with lacunar stroke in diabetes mellitus (DM).
  
  
  METHODS
  A total of 2141 consecutive patients with acute ischemic stroke were enrolled from March 2005 to April 2014, excluding the subjects with undetermined/other determined etiology or no lipid data. We compared the lipid profiles among stroke subtypes. The estimated serum TG levels and the interaction between DM and stroke subtypes were determined by analysis of covariance (ANCOVA) and Tukey's multiple comparison.
  
  
  RESULTS
  In ANCOVA test, the difference of estimated TG between DM and non-DM patients was largest in small-vessel occlusion (SVO; 159.7 [95% confidence interval {CI}, 143.2-176.2] versus 122.4 [95% CI, 106.1-138.7]), and a significant interaction was observed between DM and stroke subtypes for TG levels (P = .013) but not for total cholesterol (P = .363), low-density lipoprotein cholesterol (P = .171), or high-density lipoprotein cholesterol (P = .231). By Tukey's multiple comparison, SVO was consistently associated with DM for serum TG levels (P < .001).
  
  
  CONCLUSIONS
  In acute ischemic stroke with DM, serum TG level was significantly associated with lacunar infarction adjusting for other lipid profiles and vascular risk factors. Further studies are warranted to reveal the pathophysiologic implication of hypertriglyceridemia for lacunar infarction in type 2 DM.
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Shin
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea. Electronic address: kblee@schmc.ac.kr.
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Seo
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Ji-Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Hakjae
authors.initials: H
authors.lastname: Roh
authors.affiliation: Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Korea.
authors.forename: Moo-Young
authors.initials: MY
authors.lastname: Ahn
authors.affiliation: Department of Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Ji-Sung
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000209:etiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications; D059409:Stroke, Lacunar / Q000209:etiology*
chemical_list: D008055:Lipids; D002784:Cholesterol
keywords: Hypertriglyceridemia; acute ischemic stroke; diabetes mellitus; lacunar infarcts