LDL phenotype B and other lipid abnormalities in patients with large vessel disease and small vessel disease

• Published in: Journal of the neurological sciences Vol. 214; no. 1; pp. 11 - 16
• Main Authors: Slowik, Agnieszka, Iskra, Tomasz, Turaj, Wojciech, Hartwich, Jadwiga, Dembinska-Kiec, Aldona, Szczudlik, Andrzej
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier B.V 15.10.2003; Elsevier Science
• Subjects: Aged; Apolipoproteins E - blood; Biological and medical sciences; Brain Ischemia - blood; Brain Ischemia - epidemiology; Brain Ischemia - genetics; Cerebral Arteries - pathology; Cerebral Arteries - physiopathology; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cholesterol, LDL - genetics; Female; Humans; Hyperlipidemias - blood; Hyperlipidemias - epidemiology; Hyperlipidemias - genetics; Intracranial Arteriosclerosis - blood; Intracranial Arteriosclerosis - epidemiology; Intracranial Arteriosclerosis - genetics; Large vessel disease; LDL phenotype B; Lipoprotein(a) - blood; Male; Medical sciences; Middle Aged; Neurology; Phenotype; Prevalence; Risk Factors; Small vessel disease; Stroke - blood; Stroke - epidemiology; Stroke - genetics; Triglycerides - blood; Tropical medicine; Vascular diseases and vascular malformations of the nervous system; Large vessel disease; Small vessel disease; LDL phenotype B; Human; Nervous system diseases; Stroke; Cardiovascular disease; Exploration; Cerebral disorder; Vascular disease; Lipoprotein LDL; Phenotype; Central nervous system disease; Cerebrovascular disease
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/S0022-510X(03)00166-7

Background and purpose: Controversies concerning the significance of lipid abnormalities in stroke come mostly from the researches that studied lipid profile without considering stroke aetiologies. We investigated the prevalence of LDL phenotype B and other lipid abnormalities in stroke survivors with large vessel disease (LVD) or small vessel disease (SVD) (TOAST criteria) and in control subjects (CS). Methods: We studied 30 patients with LVD and 41 patients with SVD screened out of 585 stroke patients and 30 CS who fulfilled the following exclusion criteria: cardiac disorders, renal or hepatic failure, diabetes mellitus, or treatment with lipid-lowering agents. At least 3 months after stroke, the concentrations of total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TGs), apolipoprotein E (apoE), and lipoprotein (a) [lp(a)] were measured and LDL phenotypes and apoE isoforms were identified. Results: Patients with LVD had significantly higher concentrations of LDL-C than CS ( p<0.05). They had higher concentrations of TGs and lower concentrations of HDL-C than patients with SVD and CS ( p<0.05). LDL phenotype B was more frequent in patients with LVD (63.3%) than in patients with SVD (39.0%) or in CS (16.7%) ( p<0.05). The concentration of apoE was higher in patients with LVD than in patients with SVD or in CS ( p<0.05). The percentage of patients with increased level of lp(a) (i.e., >30 mg/ml) was greater in patients with LVD (36.7%) than in CS (10%) ( p<0.05). Conclusions: Patients with stroke due to LVD, but not SVD, have high prevalence of atherogenic lipid abnormalities, including increased frequency of LDL phenotype B and higher percentage of increased lp(a) level, like patients with other atherogenic diseases.