Study of genetic, metabolic and inflammatory risk factors in patients of acute ischemic stroke

被引：4
作者：
Dhamija R.K. [1 ]
Arora S. [2 ,4 ]
Gaba P. [1 ]
Jais M. [3 ]
Kaintura A. [1 ]
Kumar M. [1 ]
Bhattacharjee J. [2 ]
机构：
[1] Department of Medicine, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital
[2] Department of Biochemistry, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital
[3] Department of Microbiology, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital
[4] Department of Biochemistry, GB Pant Hospital, New Delhi-02, 418, Academic Block
来源：
Indian Journal of Clinical Biochemistry | 2008年 / 23卷 / 2期
关键词：
Atherogenic indices; C - reactive protein; Ischemic stroke; Lipid profile; Lipoprotein (a);
D O I：
10.1007/s12291-008-0031-5
中图分类号：
学科分类号：
摘要：
Stroke is the third leading cause of death and foremost cause of disability. Based on studies in CAD patients, a focus has been shifted on genetic and inflammatory markers as risk factors for stroke besides deranged lipid profile. The present study was aimed to ascertain the role of Lipoprotein (a), C-Reactive protein (CRP) levels and lipids in patients of ischemic stroke. The study was done in 82 subjects including 40 Computerized Tomography (CT) proven patients of ischemic stroke and 42 age and sex matched controls. Complete biochemical parameters including lipid profile were carried out on autoanalyzer using standard kits and reagents. Lipoprotein (a) [Lp(a)] was determined by immunoturbidimetric assay. Atherogenic indices (Total cholesterol/ HDL, LDL/HDL and Lipid Tetrad Index) were calculated using these lipid parameters. The CRP levels were measured semi-quantitatively by latex agglutination test method. Out of 40 stroke patients, 38 had abnormalities in lipid profile (As per ATP III guidelines). A significant difference was seen in serum cholesterol, LDL cholesterol and atherogenic indices between the patients and controls. The difference in CRP levels in cases and control subjects was highly significant (4.78± 0.72 mg/dl vs 0.76 ±0.70, p<0.001). 96.5% of patients with raised CRP had abnormal lipid levels also. CRP levels in stroke patients showed significant correlation with total cholesterol and LDL (p<0.001), Lp (a) (p=0.002) and atherogenic indices (p<0.05). Raised CRP levels in stroke patients were significantly associated with large territory infarcts, severe disability and poor functional outcome (p<0.05). Genetic [Lp(a)], metabolic (deranged Lipid profile) and inflammatory factors (CRP) together are instrumental in causing cerebrovascular arteriosclerosis leading to ischaemic stroke and can be used as important markers to identify patients at risk of severe stroke and to institute aggressive preventive strategies.
引用
收藏
页码：136 / 143
页数：7
相关论文
共 37 条
[1]  
Sethi P.K., Stroke- Incidence in India and management of ischemic stroke, Neurosciences, 6, 3, pp. 139-143, (2002)
[2]  
Rosamond W., Flegal K., Friday G., Et al., Heart disease and stroke statistics - 2007 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Circulation, 115, (2007)
[3]  
Mackay J., Mensah G.A., The Atlas of Heart Disease and Stroke, WHO in collaboration with USA's Centers for Disease Control and Prevention (CDC), (2004)
[4]  
Dalal P., Bhattacharjee M., Vairale J., Bhat P., UN millennium development goals: Can we halt the stroke epidemic in India?, Ann Indian Acad Neurol, 10, pp. 130-136, (2007)
[5]  
Enas E.A., Why is there an epidemic of Malignant CAD in young Indians? Asian, J of Clin Cardiol, 1, pp. 43-59, (1998)
[6]  
Enas E.A., Coronary artery epidemic in Indians: A cause for alarm and call for action, JIMA, 98, pp. 694-702, (2000)
[7]  
Tanne D., Benderly M., Goldbourt U., Haim M., Tenenbaum A., Fisman E.Z., Matas Z., Adler Y., Zimmlichman R., Behar S., C-Reactive Protein as a Predictor of Incident Ischemic Stroke Among Patients With Preexisting Cardiovascular Disease, Stroke, 37, pp. 1720-1724, (2006)
[8]  
Rost N.S., Wolf P.A., Kase C.S., Kelly-Hayes M., Silbershatz H., Massaro J.M., D'Agostino R.B., Franzblau C., Wilson P.W., Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: The Framingham Study, Stroke, 32, pp. 2575-2579, (2001)
[9]  
Curb J.D., Abbott R.D., Rodriguez B.L., Sakkinen P., Popper J.S., Yano K., Tracy R.P., C-reactive protein and the future risk of thromboembolic stroke in healthy men, Circulation, 107, pp. 2016-2020, (2003)
[10]  
Wakugawa Y., Kiyohara Y., Tanizaki Y., Kubo M., Ninomiya T., Hata J., Doi Y., Okubo K., Oishi Y., Shikata K., Yonemoto K., Maebuchi D., Ibayashi S., Iida M., C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population: The Hisayama Study, Stroke, 37, pp. 27-32, (2005)
1234