Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the Apolipoprotein MOrtality RISk study (AMORIS)
Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the Apolipoprotein MOrtality RISk study (AMORIS)
复制标题
DOI：
10.1111/j.1365-2796.2008.02016.x
复制
发表时间：
2009-02-01
影响因子：
11.1
通讯作者：
Walldius, G.
中科院分区：
文献类型：
--
作者：
Holme, I.;Aastveit, A. H.;Walldius, G.
在载脂蛋白死亡风险（AMORIS）研究中，按年龄和性别比较与缺血性和出血性卒中相关的脂蛋白组分（n = 148 600）。前瞻性随访研究（11.8，范围7-17岁）的致命性和非致命性缺血性和出血性中风，通过与瑞典医院出院和死亡登记的联系。缺血性卒中比出血性卒中更常见（5：1），但出血性卒中的病死率更高。在两种性别中，apoB/apoA-1比值升高、甘油三酯、非HDL胆固醇、低HDL胆固醇和总胆固醇与高密度胆固醇（TC/HDL-C）比值升高与非致死性和致死性缺血性卒中以及所有脑血管事件（n = 7480）的发生率增加相关。非致死性事件的相关性略强于致死性事件。在缺血性卒中中，在所有受试者、65岁以下受试者和LDL-C低于3 mmol L-1受试者中，apoB/apoA-1比值是比TC/HDL-C比值更强的预测因子。出血性卒中与致动脉粥样硬化性脂蛋白升高无关，除了apoB/apoA-I比值高的女性致死性出血性卒中风险增加。血脂异常与缺血性卒中风险增加相关，但在出血性卒中中几乎没有发现相关性。使用apoB/apoA-I比值作为血脂异常的标志物至少与常规脂质一样有效，用于识别卒中风险增加的受试者，尤其是缺血性卒中。实际优势，不需要禁食，支持使用apoB和apoA-1预测卒中风险。
To compare lipoprotein components associated with ischaemic and haemorrhagic stroke by age and gender in the Apolipoprotein MOrtality RISk (AMORIS) Study (n = 148 600).Prospective follow-up study (11.8, range 7-17 years) of fatal and nonfatal ischaemic and haemorrhagic stroke through linkage with Swedish hospital discharge and mortality registers.Measurements of lipoprotein components from health check-ups in the larger Stockholm area.Ischaemic stroke was more common than haemorrhagic stroke (5 :1), but case fatality was higher in haemorrhagic stroke. An elevated apoB/apoA-1 ratio and triglycerides, non-HDL cholesterol, low HDL cholesterol, and the total cholesterol to high-density cholesterol (TC/HDL-C) ratio were associated with increased incidence of nonfatal and fatal ischaemic stroke as well as all cerebrovascular events (n = 7480) in both genders. The associations were somewhat stronger for nonfatal than fatal events. In ischaemic stroke the apoB/apoA-1 ratio was a stronger predictor than the TC/HDL-C ratio in all subjects, in those below 65 years of age and in those with LDL-C below 3 mmol L-1. Haemorrhagic stroke was not associated with elevated atherogenic lipoproteins except for increased risk of fatal haemorrhagic stroke in women with a high apoB/apoA-I ratio.Dyslipidaemia is associated with an increased risk of ischaemic stroke but few relations were seen in haemorrhagic stroke. Use of the apoB/apoA-I ratio as a marker of dyslipidaemia is at least as efficient as conventional lipids, for the identification of subjects at increased risk of stroke, especially ischaemic stroke. Practical advantages, fasting is not needed, speak in favour of using apoB and apoA-1 in stroke risk prediction.