title: Subacute decline in serum lipids precedes the occurrence of primary intracerebral hemorrhage.
abstract: We aimed to describe the temporal variation in circulating lipid levels among patients with intracerebral hemorrhage (ICH) and investigate their association with ICH risk.
  
  
  
  This was a single-center, retrospective, longitudinal, case-control analysis using cases drawn from an ongoing cohort study of primary ICH and controls drawn from a hospital-based clinical data registry. Piecewise linear mixed-effect random coefficient models were used to determine the significance of changes in serum lipid trends on ICH risk.
  
  
  
  Two hundred twelve ICH cases and 301 control individuals were analyzed. Overall trends in serum total cholesterol (TC) and low-density lipoprotein (LDL) levels differed between ICH cases and non-ICH controls (p = 0.00001 and p = 0.0092, respectively). Patients with ICH experience accelerated decline in serum TC and LDL levels during 6 months immediately preceding ICH, compared with levels between 6 and 24 months pre-ICH (TC: -29.25 mg/dL, p = 0.001; LDL: -21.48 mg/dL, p = 0.0038), which was not observed in non-ICH controls. Subgroup analysis confirmed that this phenomenon cannot be attributed to statin or alcohol exposure. Serum triglycerides and high-density lipoprotein trends did not differ between groups.
  
  
  
  Longitudinal lipid levels differ between ICH cases and non-ICH controls, most notably for a decline in serum TC and LDL levels within 6 months preceding primary ICH, independent of statin or alcohol use. These changes in serum TC and LDL trends suggest a biological pathway that precipitates ICH occurrence. Further studies are needed to replicate these results and characterize rate of change in serum lipids as a potential biomarker of impending acute cerebral injury.
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Phuah
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Raffeld
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Ayres
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Anand
authors.initials: A
authors.lastname: Viswanathan
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Greenberg
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Biffi
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rosand
authors.affiliation: From the Division of Neurocritical Care and Emergency Neurology (C.-L.P., J.R., C.D.A.), Center for Human Genetic Research (C.-L.P., M.R.R., A.B., J.R., C.D.A.), The J. Philip Kistler Stroke Research Center (A.M.A., A.V., S.M.G., J.R., C.D.A.), and Hemorrhagic Stroke Research Group (A.M.A., A.V., S.M.G., A.B., J.R., C.D.A.), Massachusetts General Hospital, Boston; and Program in Medical and Population Genetics (C.-L.P., A.B., J.R., C.D.A.), Broad Institute, Cambridge, MA. cdanderson@mgh.harvard.edu.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Anderson
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000188:drug therapy; D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; D014280:Triglycerides; D002784:Cholesterol