The triglyceride:high-density lipoprotein-cholesterol ratio and steno-occlusive disease in the intracranial arteries

The extent of carotid artery atherosclerosis correlates with increased plasma concentrations of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) and with a decreased plasma concentration of high-density lipoprotein-cholesterol (HDL-C). However, emerging data suggest that a triglyceride (TG):HDL-C ratio may be a better predictor of vascular risk than the traditional lipid measures such as TC and LDL-C. The purpose of this study was to evaluate the association between TC, LDL-C, TG, HDL-C, and the TG: HDL-C ratio with steno-occlusive disease in the intracranial cerebral arteries. We analyzed the records of 361 stroke-free subjects who underwent brain magnetic resonance angiography as part of their voluntary health checks. The presence of a steno-occlusive lesion in the basilar artery (BA) and in the horizontal portion of the middle cerebral artery (MCA) was assessed using brain 3D time of flight magnetic resonance angiography. All patients had fasting lipid panels drawn. We categorized serum lipid indices into quartiles and logistic regression analyses were performed. No serum lipid index was associated with the prevalence of MCA disease; TC, LDL-C, and HDL-C concentrations were not correlated with the prevalence of BA disease. A TG concentration in the third quartile compared with the lowest quartile was associated with increased prevalence of BA disease. The TG: HDL-C ratios in the upper three quartiles compared with the lowest quartile were associated with increased prevalence of BA disease. In conclusion, the TG: HDL-C ratio is more highly associated with the intracranial steno-occlusive disease than any standard lipid measure.