Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups
Association of cholesterol with stroke risk varies in stroke subtypes and patient subgroups
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DOI：
10.1212/01.wnl.0000144282.42222.da
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发表时间：
2004-11-23
期刊：
影响因子：
9.9
通讯作者：
Psaty, BM
中科院分区：
文献类型：
--
作者：
Tirschwell, DL;Smith, NL;Psaty, BM
目的：开展以健康维护组织为基础的病例对照研究，以评估总胆固醇和高密度脂蛋白胆固醇与卒中亚型和患者亚组之间的关系。方法：确诊为缺血性卒中患者1242例，出血性卒中患者313例。对照组(n=6,455)是在伴随的心肌梗死研究中确定的。卒中风险采用Logistic回归进行建模。结果：与总胆固醇水平最低的五分位数(OR=1.6，95%CI 1.3~2.0)相比，总胆固醇水平最高的五分位数与缺血性卒中的风险增加相关(OR=1.6，95%CI 1.3~2.0)，与动脉粥样硬化性卒中(OR=3.2)和腔隙性卒中(OR=2.4)的相关性最强。与高密度脂蛋白胆固醇水平最低的五分位数相比，高密度脂蛋白胆固醇水平的五分位数与缺血性卒中的风险降低相关(OR=0.8，CI为0.6~1.0)。亚组分析表明，总胆固醇相关性对患者更重要。
Objective: To perform a health maintenance organization-based case-control study to evaluate the association of total and high density lipoprotein (HDL) cholesterol with the risk of stroke subtypes and in patient subgroups. Methods: Cases had a confirmed incident ischemic stroke (n = 1,242) or hemorrhagic stroke (n = 313). Controls (n = 6,455) were identified in a companion myocardial infarction study. Risk of stroke was modeled using logistic regression. Results: The highest total cholesterol quintile was associated with an increased risk of ischemic stroke compared to the lowest quintile (OR = 1.6, 95% CI 1.3 to 2.0) with the strongest subtype associations for atherosclerotic stroke (OR = 3.2) and lacunar stroke (OR = 2.4). The highest HDL cholesterol quintile was associated with a decreased risk of ischemic stroke compared to the lowest quintile (OR = 0.8, CI 0.6 to 1.0). Subgroup analyses suggested that the total cholesterol association was more important for patients