title: Paradoxical Elevation of High Density Lipoprotein Cholesterol in Association with Lacunar-Type Cerebral Infarction.
abstract: BACKGROUND
  The aim of this study was to evaluate the association between high-density lipoprotein cholesterol (HDLC) levels and the risk of lacunar infarction (LI) in a retrospective cohort study in China.
  
  
  METHODS
  We recruited 229 patients with obsolete brain infarctions single side (SOBI), 218 with obsolete brain infarctions bilateral sides (BOBI), 193 with both acute stroke and obsolete lacunar infarctions single side (AI&SOBI), 113 with both acute stroke and obsolete lacunar infarctions bilateral sides (AI&BOBI), and 203 without any infarctions (Control).
  
  
  RESULTS
  1) The plasma levels of HDLC in group BOBI, AI&SOBI, and AI&BOBI were higher than in the control group, and lower in group SOBI than in the control group (p<0.01). 2) The plasma levels of HDLC in group AI&SOBI were significantly higher than in group SOBI (p<0.01). 3) The plasma levels of HLDL were similar between group AI&SOBI and AI&BOBI. 4) There were significant relationships between HDLC and acute lacunar stroke, even after adjusting for these factors such as age, sex, triglyceride, total cholesterol, low-density lipoprotein cholesterol, and history of diabetes (p=0.001). 4) Compared with the controls, the calculation of odds ratios indicated relative risk estimates of higher HDLC for acute lacunar stroke with obsolete lacunar infarction.
  
  
  CONCLUSIONS
  Elevated HDLC may be an independent predictor of recurrent stroke with obsolete lacunar infarctions single side in Chinese people, justifying clinical trials for secondary prevention of stroke by generally increasing HLDL level. According to the difference between single and bilateral side multiple silent lacunar infarcts, it is inferred that HDLC may increase the risk of atherothrombotic infarction but reduce the risk of cardioembolic infarction in the general Chinese population.
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Gui-Lin
authors.initials: GL
authors.lastname: Meng
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Yan
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Min
authors.initials: M
authors.lastname: Fang
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Yang
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Xue-Yuan
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Neurology, Tenth People's Hospital, Tongji University, Shanghai, China (mainland).
authors.forename: Yan-Xin
authors.initials: YX
authors.lastname: Zhao
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D059409:Stroke, Lacunar / Q000097:blood*
chemical_list: D008076:Cholesterol, HDL