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

TitleAssociation of Lipids With Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study Among 267 500 Chinese
Authors
Keywordscholesterol
triglyceride
stroke
Issue Date2019
PublisherAmerican Heart Association. The Journal's web site is located at http://stroke.ahajournals.org
Citation
Stroke, 2019, v. 50 n. 12, p. 3376-3384 How to Cite?
AbstractBackground 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 267 500 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 2 295 881 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.
Persistent Identifierhttp://hdl.handle.net/10722/279897
ISSN
2017 Impact Factor: 6.239
2015 SCImago Journal Rankings: 3.671

 

DC FieldValueLanguage
dc.contributor.authorGu, X-
dc.contributor.authorLi, Y-
dc.contributor.authorCheng, S-
dc.contributor.authorYang, X-
dc.contributor.authorLiu, F-
dc.contributor.authorLi, Y-
dc.contributor.authorLi, J-
dc.contributor.authorCao, J-
dc.contributor.authorLiu, X-
dc.contributor.authorChen, J-
dc.contributor.authorShen, C-
dc.contributor.authorYu, L-
dc.contributor.authorHuang, J-
dc.contributor.authorLam, TH-
dc.contributor.authorFang, XH-
dc.contributor.authorHe, Y-
dc.contributor.authorZhang, XH-
dc.contributor.authorLu, XF-
dc.contributor.authorWu, SL-
dc.contributor.authorGu, D-
dc.date.accessioned2019-12-23T08:23:22Z-
dc.date.available2019-12-23T08:23:22Z-
dc.date.issued2019-
dc.identifier.citationStroke, 2019, v. 50 n. 12, p. 3376-3384-
dc.identifier.issn0039-2499-
dc.identifier.urihttp://hdl.handle.net/10722/279897-
dc.description.abstractBackground 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 267 500 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 2 295 881 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.-
dc.languageeng-
dc.publisherAmerican Heart Association. The Journal's web site is located at http://stroke.ahajournals.org-
dc.relation.ispartofStroke-
dc.subjectcholesterol-
dc.subjecttriglyceride-
dc.subjectstroke-
dc.titleAssociation of Lipids With Ischemic and Hemorrhagic Stroke: A Prospective Cohort Study Among 267 500 Chinese-
dc.typeArticle-
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hk-
dc.identifier.emailHe, Y: yaohe@hkucc.hku.hk-
dc.identifier.authorityLam, TH=rp00326-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1161/STROKEAHA.119.026402-
dc.identifier.pmid31658904-
dc.identifier.scopuseid_2-s2.0-85075812970-
dc.identifier.hkuros308695-
dc.identifier.volume50-
dc.identifier.issue12-
dc.identifier.spage3376-
dc.identifier.epage3384-
dc.publisher.placeUnited States-

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