Association between lipoprotein(a) and ischemic stroke: Fibrinogen as a mediator.

BACKGROUND: Previous studies have reported lipoprotein(a) was related to increased risk of ischemic stroke. However, the role of fibrinogen in their associations was not fully elucidated. AIM: We aimed to investigate the mediating role of fibrinogen in the association between lipoprotein(a) and risk of ischemic stroke. METHODS: A total of 516 patients with ischemic stroke were matched 1:1 to patients without ischemic stroke for age and gender. Serum lipoprotein(a) and plasma fibrinogen levels were collected on the basis of the results of biochemical tests. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for lipoprotein(a) levels and ischemic stroke risk. Mediation analysis were further conducted to evaluate the potential mediating role of fibrinogen in the association between lipoprotein(a) and ischemic stroke risk. RESULTS: The lipoprotein(a) level of subjects with ischemic stroke was significantly higher than that of subjects without ischemic stroke (P < 0.001). Each SD increment of lipoprotein(a) was associated with 27% higher odds (OR 1.27, 95%CI: 1.11, 1.45) increment in ORs of ischemic stroke. Furthermore, mediation analyses indicated that fibrinogen mediated 10.15% of the associations between lipoprotein(a) and ischemic stroke. CONCLUSIONS: Higher level of lipoprotein(a) was independently associated with increased risk of ischemic stroke and fibrinogen partially mediated the associations of lipoprotein(a) and ischemic stroke risk.

Impaired sensitivity to thyroid hormones is associated with ischemic stroke in young and middle-aged euthyroid population / 西安交通大学学报(医学版)

【Objective】 To investigate the association of thyroid indices with the prevalence of ischemic stroke in young and middle-aged euthyroid population. 【Methods】 For this retrospective study, 620 euthyroid patients aged from 18 to 65 years were divided into ischemic stroke group (n=308) and non-ischemic stroke group (n=312). The characteristics of the study population; serum thyroid indices, i.e., free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), were collected from biochemical test results. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid indices and ischemic stroke. 【Results】 Compared with non-ischemic stroke group, significant differences were observed in age, gender, weight, smoking status, drinking status, history of hypertension and diabetes, SBP, DBP, FBG, TC, HDL-C, LDL-C, FT3, FT4, FT3/FT4, TFQI, and PTFQI in ischemic stroke patients (all P0.05). Logistic regression analysis revealed that lower FT3 [OR (95% CI) =0.722 (0.547~0.955) , P=0.022] and FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.001] , FT4 [OR (95% CI) =1.099 (1.011~1.194) , P=0.026] were significantly associated with an increased risk of ischemic stroke. After stratified analysis by hypertension, FT4 [OR (95% CI) =1.133 (1.021~1.257) , P=0.019] , lower FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.003] , TFQI [ OR (95% CI) =1.854 (1.026~3.350) , P=0.041] , and PTFQI [OR (95% CI) =1.871 (1.065~3.288) , P=0.029] were significantly associated with an increased risk of ischemic stroke in patients combined with hypertension, while after stratified analysis by diabetes, we only found that lower FT3/FT4 ratio [OR (95% CI) =0.730 (0.559~0.953) , 0.704 (0.536~0.944) , P=0.021] and FT4 [OR (95% CI) =1.170 (1.025~1.335) , P=0.026] were significantly associated with an increased risk of ischemic stroke in patients combined with diabetes. 【Conclusion】 FT3, FT4, and FT3/FT4 ratio are associated with an increased risk for ischemic stroke in young and middle-aged euthyroid population; TFQI and PTFQ are associated with an increased risk for ischemic stroke in patients combined with hypertension.

Remnant cholesterol is associated with triglyceride and glucose index in young and middle-aged patients with ischemic stroke / 西安交通大学学报(医学版)

【Objective】 To investigate the association between remnant cholesterol (RC) and triglyceride and glucose (TyG) index in young and middle-aged patients with ischemic stroke. 【Methods】 A total of 268 patients were divided into two groups, namely low TyG index group (n=134) and high TyG index group (n=134). Characteristics of the study population and metabolism risk factors (TC, TG, HDL-C, LDL-C, UA) were collected from biochemical test results. Spearman correlation analysis was used to analyze the correlation between metabolism risk factors and TyG index. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for RC and TyG index. 【Results】 Compared with the low TyG index group, significant differences were observed for BMI, history of diabetes, history of hypertension, SBP, DBP, FBG, TC, TG, LDL-C, RC, UA, and TyG index in high TyG index group. No significant differences were observed in age, gender, smoking status, or drinking status, HDL-C between the two groups. Spearman correlation analysis indicated that significant linear associations were observed between BMI, SBP, DBP, FBG, TC, TG, HDL-C, LDL-C, RC, UA and TyG index. Logistic regression analysis revealed that the RC, BMI, hypertension, diabetes, TC, LDL-C, and UA were significantly associated with the risk of increased level of TyG index. After adjusted analysis by RC, BMI, hypertension, diabetes, TC, LDL-C, and UA, only RC was significantly associated with an increased risk of increased level of TyG index. 【Conclusion】 Remnant cholesterol was associated with an increased risk of elevated TyG index level in young and middle-aged patients with ischemic stroke.