Association between cholesterol levels and infections after ischemic stroke
Background and purpose Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients. Methods A single‐center prospective cohort was analyzed. Total...
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Published in | European journal of neurology Vol. 27; no. 10; pp. 2036 - 2040 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
John Wiley & Sons, Inc
01.10.2020
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Subjects | |
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Abstract | Background and purpose
Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients.
Methods
A single‐center prospective cohort was analyzed. Total (TOTc), low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were measured within 24 h from admission. The outcome of interest was the occurrence of any IC (pneumonia, urinary tract infection, sepsis, other infection) during hospitalization. Predictors of ICs were investigated with multivariable logistic regression.
Results
A total of 603 patients were included (median age 78 years, 49.3% males), of whom 134 (22.2%) developed an IC. Subjects with ICs had lower TOTc compared with patients without ICs (median 157 vs. 173 mg/dL; P < 0.001). When TOTc was stratified in quartiles, we observed a linear decrease in the prevalence of ICs with higher TOTc levels (Q1, <144 mg/dL, 32.7%; Q2, 145–168 mg/dL, 24.7%; Q3, 169–197 mg/dL, 17.8%; Q4, >197 mg/dL, 13.3% P < 0.001). The inverse relationship between TOTc and ICs remained significant after adjustment for confounders in logistic regression [odds ratio (OR) for 10 mg/dL increase, 0.92; 95% confidence intervals (CI), 0.87–0.97; P = 0.001]. This association was also confirmed for low‐density lipoprotein cholesterol (OR, 0.93; 95% CI, 0.88–0.99; P = 0.013) and high‐density lipoprotein cholesterol (OR, 0.85; 95% CI, 0.73–0.98; P = 0.026) and was not mediated by statin treatment.
Conclusion
Higher cholesterol levels are independently associated with lower risk of ICs in ischemic stroke patients. Further studies are needed to confirm our findings and characterize the biological mechanisms underlying this association. |
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AbstractList | Background and purposeMultiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients.MethodsA single‐center prospective cohort was analyzed. Total (TOTc), low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were measured within 24 h from admission. The outcome of interest was the occurrence of any IC (pneumonia, urinary tract infection, sepsis, other infection) during hospitalization. Predictors of ICs were investigated with multivariable logistic regression.ResultsA total of 603 patients were included (median age 78 years, 49.3% males), of whom 134 (22.2%) developed an IC. Subjects with ICs had lower TOTc compared with patients without ICs (median 157 vs. 173 mg/dL; P < 0.001). When TOTc was stratified in quartiles, we observed a linear decrease in the prevalence of ICs with higher TOTc levels (Q1, <144 mg/dL, 32.7%; Q2, 145–168 mg/dL, 24.7%; Q3, 169–197 mg/dL, 17.8%; Q4, >197 mg/dL, 13.3% P < 0.001). The inverse relationship between TOTc and ICs remained significant after adjustment for confounders in logistic regression [odds ratio (OR) for 10 mg/dL increase, 0.92; 95% confidence intervals (CI), 0.87–0.97; P = 0.001]. This association was also confirmed for low‐density lipoprotein cholesterol (OR, 0.93; 95% CI, 0.88–0.99; P = 0.013) and high‐density lipoprotein cholesterol (OR, 0.85; 95% CI, 0.73–0.98; P = 0.026) and was not mediated by statin treatment.ConclusionHigher cholesterol levels are independently associated with lower risk of ICs in ischemic stroke patients. Further studies are needed to confirm our findings and characterize the biological mechanisms underlying this association. Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients. A single-center prospective cohort was analyzed. Total (TOTc), low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were measured within 24 h from admission. The outcome of interest was the occurrence of any IC (pneumonia, urinary tract infection, sepsis, other infection) during hospitalization. Predictors of ICs were investigated with multivariable logistic regression. A total of 603 patients were included (median age 78 years, 49.3% males), of whom 134 (22.2%) developed an IC. Subjects with ICs had lower TOTc compared with patients without ICs (median 157 vs. 173 mg/dL; P < 0.001). When TOTc was stratified in quartiles, we observed a linear decrease in the prevalence of ICs with higher TOTc levels (Q1, <144 mg/dL, 32.7%; Q2, 145-168 mg/dL, 24.7%; Q3, 169-197 mg/dL, 17.8%; Q4, >197 mg/dL, 13.3% P < 0.001). The inverse relationship between TOTc and ICs remained significant after adjustment for confounders in logistic regression [odds ratio (OR) for 10 mg/dL increase, 0.92; 95% confidence intervals (CI), 0.87-0.97; P = 0.001]. This association was also confirmed for low-density lipoprotein cholesterol (OR, 0.93; 95% CI, 0.88-0.99; P = 0.013) and high-density lipoprotein cholesterol (OR, 0.85; 95% CI, 0.73-0.98; P = 0.026) and was not mediated by statin treatment. Higher cholesterol levels are independently associated with lower risk of ICs in ischemic stroke patients. Further studies are needed to confirm our findings and characterize the biological mechanisms underlying this association. Background and purpose Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients. Methods A single‐center prospective cohort was analyzed. Total (TOTc), low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were measured within 24 h from admission. The outcome of interest was the occurrence of any IC (pneumonia, urinary tract infection, sepsis, other infection) during hospitalization. Predictors of ICs were investigated with multivariable logistic regression. Results A total of 603 patients were included (median age 78 years, 49.3% males), of whom 134 (22.2%) developed an IC. Subjects with ICs had lower TOTc compared with patients without ICs (median 157 vs. 173 mg/dL; P < 0.001). When TOTc was stratified in quartiles, we observed a linear decrease in the prevalence of ICs with higher TOTc levels (Q1, <144 mg/dL, 32.7%; Q2, 145–168 mg/dL, 24.7%; Q3, 169–197 mg/dL, 17.8%; Q4, >197 mg/dL, 13.3% P < 0.001). The inverse relationship between TOTc and ICs remained significant after adjustment for confounders in logistic regression [odds ratio (OR) for 10 mg/dL increase, 0.92; 95% confidence intervals (CI), 0.87–0.97; P = 0.001]. This association was also confirmed for low‐density lipoprotein cholesterol (OR, 0.93; 95% CI, 0.88–0.99; P = 0.013) and high‐density lipoprotein cholesterol (OR, 0.85; 95% CI, 0.73–0.98; P = 0.026) and was not mediated by statin treatment. Conclusion Higher cholesterol levels are independently associated with lower risk of ICs in ischemic stroke patients. Further studies are needed to confirm our findings and characterize the biological mechanisms underlying this association. Background and purpose Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (ICs) in acute ischemic stroke patients. Methods A single‐center prospective cohort was analyzed. Total (TOTc), low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol levels were measured within 24 h from admission. The outcome of interest was the occurrence of any IC (pneumonia, urinary tract infection, sepsis, other infection) during hospitalization. Predictors of ICs were investigated with multivariable logistic regression. Results A total of 603 patients were included (median age 78 years, 49.3% males), of whom 134 (22.2%) developed an IC. Subjects with ICs had lower TOTc compared with patients without ICs (median 157 vs. 173 mg/dL; P < 0.001). When TOTc was stratified in quartiles, we observed a linear decrease in the prevalence of ICs with higher TOTc levels (Q1, <144 mg/dL, 32.7%; Q2, 145–168 mg/dL, 24.7%; Q3, 169–197 mg/dL, 17.8%; Q4, >197 mg/dL, 13.3% P < 0.001). The inverse relationship between TOTc and ICs remained significant after adjustment for confounders in logistic regression [odds ratio (OR) for 10 mg/dL increase, 0.92; 95% confidence intervals (CI), 0.87–0.97; P = 0.001]. This association was also confirmed for low‐density lipoprotein cholesterol (OR, 0.93; 95% CI, 0.88–0.99; P = 0.013) and high‐density lipoprotein cholesterol (OR, 0.85; 95% CI, 0.73–0.98; P = 0.026) and was not mediated by statin treatment. Conclusion Higher cholesterol levels are independently associated with lower risk of ICs in ischemic stroke patients. Further studies are needed to confirm our findings and characterize the biological mechanisms underlying this association. |
Author | Persico, A. Mazzacane, F. Leuci, E. Micieli, G. Candeloro, E. Morotti, A. Cavallini, A. |
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Cites_doi | 10.1159/000347077 10.1097/MOL.0000000000000106 10.1016/S0140-6736(15)00126-9 10.1056/NEJMcibr1412016 10.1007/s12028-016-0367-2 10.1161/01.STR.32.4.917 10.1086/383029 10.1001/jama.2016.0287 10.2741/2897 10.2307/30141957 10.1097/CCM.0b013e318225742c 10.1016/S0140-6736(14)62456-9 10.1136/jech.2003.008466 10.1146/annurev.pharmtox.45.120403.095748 10.1038/nrn1765 10.1007/s12262-015-1296-6 10.1186/1471-2377-11-110 10.1038/nri3793 10.1212/WNL.0b013e31823152b1 10.1161/STROKEAHA.115.009617 |
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Snippet | Background and purpose
Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with... Multiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious... Background and purposeMultiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with... BACKGROUND AND PURPOSEMultiple studies have suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with... |
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SubjectTerms | Cholesterol Complications Confidence intervals Density Health risks Immunomodulation Infections Ischemia Lipoproteins pneumonia Quartiles Regression analysis Sepsis Statins Statistical analysis Stroke Urinary tract urinary tract infection |
Title | Association between cholesterol levels and infections after ischemic stroke |
URI | https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fene.14364 https://www.ncbi.nlm.nih.gov/pubmed/32460442 https://www.proquest.com/docview/2442707332/abstract/ https://search.proquest.com/docview/2407584534 |
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