Association of Lipids With Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study Among 267 500 Chinese

被引：117

作者：

Gu, Xiaoying ^{[1
]}

Li, Yunzhi ^{[1
]}

Chen, Shuohua ^{[2
]}

Yang, Xueli ^{[1
]}

Liu, Fangchao ^{[1
]}

Li, Ying ^{[1
]}

Li, Jianxin ^{[1
]}

Cao, Jie ^{[1
]}

Liu, Xiaoqing ^{[3
]}

Chen, Jichun ^{[1
]}

Shen, Chong ^{[4
]}

Yu, Ling ^{[5
]}

Huang, Jianfeng ^{[1
]}

Lam, Tai-Hing ^{[6
]}

Fang, Xianghua ^{[7
]}

He, Yao ^{[8
]}

Zhang, Xinhua ^{[9
]}

Lu, Xiangfeng ^{[1
]}

Wu, Shouling ^{[2
]}

Gu, Dongfeng ^{[1
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Dept Epidemiol,State Key Lab Cardiovasc Dis, 167 Beilishi Rd, Beijing 100037, Peoples R China

[2] Hebei United Univ, Kailuan Hosp, Dept Cardiol, Tangshan, Peoples R China

[3] Guangdong Prov Peoples Hosp & Cardiovasc Inst, Div Epidemiol, Guangzhou, Guangdong, Peoples R China

[4] Nanjing Med Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Nanjing, Jiangsu, Peoples R China

[5] Fujian Prov Peoples Hosp, Dept Cardiol, Fuzhou, Fujian, Peoples R China

[6] Univ Hong Kong, Sch Publ Hlth, Hong Kong, Peoples R China

[7] Capital Med Univ, Xuanwu Hosp, Evidence Based Med Ctr, Beijing, Peoples R China

[8] Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Inst Geriatr, Beijing Key Lab Aging & Geriatr, Beijing, Peoples R China

[9] Beijing Hypertens League Inst, Beijing, Peoples R China

来源：

STROKE | 2019年 / 50卷 / 12期

关键词：

cholesterol; stroke; triglyceride; DENSITY-LIPOPROTEIN CHOLESTEROL; SERUM TOTAL CHOLESTEROL; RISK-FACTORS; CEREBRAL MICROBLEEDS; GLOBAL BURDEN; PREVALENCE; DISEASE; POPULATION; INFARCTION; MORTALITY;

D O I：

10.1161/STROKEAHA.119.026402

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-Previous results on the association between lipids and stroke were controversial. We investigated the association of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C ), high-density lipoprotein cholesterol (HDL-C), and triglyceride with stroke. Methods-Six cohort studies in China with 267500 participants were included. Cox proportional hazards regression models and restricted cubic spline analyses were used to estimate hazard ratios and 95% CIs and explore linear and nonlinear relationships of lipids and stroke, respectively. Results-The median follow-up duration ranged from 6 to 19 years. During 2295881 person-years, 8072 people developed stroke. Multivariable adjusted hazard ratios (95% CIs) per 1 mmol/L increase in TC, LDL-C, triglyceride were 1.08 (1.05-1.11), 1.08 (1.04-1.11), 1.07 (1.05-1.09) for ischemic stroke, respectively. Compared with participants with TC 160-199.9 mg/dL, hazard ratios (95% CIs) were 1.43 (1.11-1.85) for hemorrhagic stroke in those with TC <120 mg/dL. Compared with participants with HDL-C 50 to 59.9 mg/dL, hazard ratios (95% CIs) were 1.23 (1.12-1.35), 1.13 (1.04-1.22) for ischemic stroke, and 1.28 (1.10-1.49), 1.17 (1.03-1.33) for hemorrhagic stroke in those with HDL-C <40 and 40 to 49.9 mg/dL, respectively. Restricted cubic spline analyses showed linear relationships of TC and LDL-C, and nonlinear relationships of HDL-C and triglyceride with ischemic stroke (all P<0.001). Hemorrhagic stroke showed linear relationships with TC and HDL-C (P=0.029 and <0.001 respectively), but no relationship with LDL-C and triglyceride (all P>0.05). Conclusions-TC, LDL-C, and triglyceride showed positive associations with ischemic stroke. The risk of hemorrhagic stroke was higher when TC was lower than 120 mg/dL. LDL-C and triglyceride showed no association with hemorrhagic stroke. The risks of ischemic and hemorrhagic stroke might be higher when HDL-C was lower than 50 mg/dL.

引用

页码：3376 / 3384

页数：9

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