Low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio predicts asymptomatic carotid plaques and their stability in high-risk stroke population / 国际脑血管病杂志

Objective To investigate the relationship between low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LHR) and asymptomatic carotid plaques and their stability in high-risk stroke population.Methods Between December 2012 and April 2015,a total of 39 944 permanent resident population ≥40 years were used as subjects of the survey from 11 rural communities in Haitou Town,Banzhuang Town and Tashan Town,Ganyu District,and 9 urban communities in Xinpu District and Haizhou District,Lianyungang City using epidemiological survey method of cluster sampling.Excluding those who took lipid-lowering drugs within 3 months and had a history of stroke or transient ischemic attack,6 592 people at high risk of stroke were finally screened out.Ultrasound was used to detect carotid plaques.The subjects were divided into plaque-free group and plaque group.The latter was further divided into stable plaque group and unstable plaque group.Multivariate logistic regression analysis was used to evaluate the independent risk factor for carotid plaques and their stability.The odds ratio (OR) and 95％ confidence interval (CI) were calculated.Receiver Operating Characteristic (ROC) curve was used to evaluate the prediction efficiency of LHR on carotid plaques.Results Multivariate logistic regression analysis showed that low-density lipoprotein cholesterol (LDL-C) was an independent risk factor for carotid plaques,while high-density lipoprotein cholesterol (HDL-C) was an independent protection factor of carotid plaques.Using the lowest quintile (Q1) of LHR as a reference,carotid plaque risk increased significantly with the increasing LHR (Q2:OR 1.448,95％ CI 1.082-1.937,P =0.013;Q3:OR 2.414,95％ CI 1.754-3.322,P＜0.001;Q4:OR 2.939,95％ CI 1.945-4.441,P＜0.001;Q5:OR 4.884,95％ CI 3.143-7.115,P＜0.001).ROC curve analysis showed that the area under the curve (AUC) of LHR predicting carotid plaques was 0.795 (95％ CI 0.792-0.807;P＜ 0.001),and the optimal cut-off value was 3.00 (sensitivity 68.37％,specificity 75.65％).LHR ≥3.92 (LHR in the Q4 and Q5 subgroups) was an independent risk factor for unstable carotid plaques (OR 2.915,95％ CI 2.104-4.040;P＜0.001).The AUC of the LHR predicting unstable carotid plaques was 0.658 (95％ CI 0.633-0.684;P＜0.001).Conclusions LHR was an independent predictor of carotid plaques in high-risk stroke patients.It had higher predictive value for carotid plaques,and its conversion threshold for promoting plaque formation was 3.00.When LHR was ≥3.92,there was a significant increase in the risk of unstable carotid plaques.

Low Density Lipoprotein-Cholesterol/High Density Lipoprotein-Cholesterol Ratio Predicts Plaque Vulnerability in Patients With Stable Angina

BACKGROUND AND OBJECTIVES: The relationship between lipid profile and coronary plaque tissue characteristics in patients with stable angina pectoris (SAP) is unclear. The aim of this study was to evaluate the relationship between tissue characteristics and lipid profile and predictors of unstable plaques (UPs) in patients with SAP by virtual histology intravascular ultrasonography (VH-IVUS). SUBJECTS AND METHODS: VH-IVUS was performed for target lesions in patients with SAP (61.7+/-9.2 years, 174 males, n=266) at the time of coronary angiography. UPs are characterized by thin-cap fibroatheroma, ruptured plaque, or remaining thrombus with VH-IVUS. RESULTS: The present study showed that 34 SAP patients had UPs (61.6+/-9.2 years, 24 males, 12.8%). The percentage of plaque area in the minimum luminal area in high low density lipoprotein-cholesterol (LDL-C)/high density lipoprotein-cholesterol (HDL-C) ratio patients was significantly higher than in low LDL-C/HDL-C ratio patients (72.7+/-9.5% vs. 69.9+/-9.3%, p=0.035). An LDL-C/HDL-C ratio >2.0 was an independent predictor for UPs in SAP patients (odds ratio 5.252, 95% confidence interval 1.132-24.372, p=0.034). CONCLUSION: An elevated LDL-C/HDL-C ratio is a positive predictor for coronary plaque vulnerability in patients with SAP.

Relationship between Leukoaraiosis and Blood Lipid Levels / 中国康复理论与实践

@# Objective To investigate the relationship between blood lipids levels and leukoaraiosis (LA). Methods 322 cases were designed into non-LA group (n=141) and LA group (n=181) according to MRI. LA group was further designed into mild (Fazekas Ⅰ, n=57),moderate (Fazekas Ⅱ, n=52), and severe (Fazekas Ⅲ, n=72) groups according to Fazekas classification. Their blood lipids levels were compared.Results The level of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) increased (P<0.05) with the level of LA,while the level of triglycerides (TG) increased in all the LA groups (P<0.05), but no significant difference among them (P>0.05). There was no significant difference among all the groups in high-density lipoprotein cholesterol (HDL-C) (P>0.05). Conclusion TC, TG, and LDL-Cincrease in those with LA, and the TC and LDL-C increase with the severity of LA. The HDL-C do not relate with LA.

Relationship between Leukoaraiosis and Blood Lipid Levels / 中国康复理论与实践

@# Objective To investigate the relationship between blood lipids levels and leukoaraiosis (LA). Methods 322 cases were designed into non-LA group (n=141) and LA group (n=181) according to MRI. LA group was further designed into mild (Fazekas Ⅰ, n=57),moderate (Fazekas Ⅱ, n=52), and severe (Fazekas Ⅲ, n=72) groups according to Fazekas classification. Their blood lipids levels were compared.Results The level of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) increased (P<0.05) with the level of LA,while the level of triglycerides (TG) increased in all the LA groups (P<0.05), but no significant difference among them (P>0.05). There was no significant difference among all the groups in high-density lipoprotein cholesterol (HDL-C) (P>0.05). Conclusion TC, TG, and LDL-Cincrease in those with LA, and the TC and LDL-C increase with the severity of LA. The HDL-C do not relate with LA.

The Association between Intraocular Pressure and Predictors of Coronary Heart Disease Risk in Koreans

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucomatous visual field defects. Each individual systemic risk factor of coronary heart disease (CHD) is associated with elevated IOP, although no reports have argued for a correlation between the risk factors for CHD and IOP after a comprehensive or collective analysis. The National Cholesterol Education Program Adult Treatment Panel III presented the Framingham projection, which can predict the risk of CHD quantitatively. We investigated the association between IOP and the Framingham projection in 16,383 Korean subjects. The Framingham projection was applied using the indicated risk factors. The associations between the Framingham projection and IOP and the influences of the risk factors on the IOP were examined. The Framingham projection was correlated with the mean IOP in women (p<0.05). The relationship between IOP and systemic variables other than smoking was significant (p<0.05). The mean IOP was significantly higher in the high-risk CHD group than in the low-risk group based on the Framingham projection (p<0.05). Because an elevated IOP was associated with cardiovascular risk factors, subjects with a high CHD risk based on the Framingham projection need continuous monitoring for IOP to prevent glaucomatous visual field defects.