Association between Apolipoproteins AI and B and Ultrasound Indicators of Carotid Atherosclerosis
Zeljko Zivanovic1,2, Ivana Divjak1,2, Mirjana Jovicevic1,2
1Faculty of Medicine University Novi Sad, Novi Sad, Serbia.
Insights
Apolipoprotein A-I and B levels are strongly linked to carotid atherosclerosis indicators in ischemic stroke patients. These apolipoproteins, along with the apoB/apoA-I ratio, show significant associations with ultrasound markers of disease.
Area of Science:
- Cardiology
- Neurology
- Biochemistry
Background:
- Cardiovascular and cerebrovascular disease risk may be better predicted by apolipoproteins A-I and B (apoA-I and apoB) than traditional risk factors.
- Carotid artery atherosclerosis, detectable by ultrasound, can precede ischemic stroke (IS).
- A carotid etiology is not present in all IS patients.
Purpose of the Study:
- To investigate the association between ultrasound-detected carotid atherosclerosis and apolipoprotein levels in IS patients.
- To explore the relationship between apoA-I, apoB, and other biomarkers with carotid atherosclerosis indicators.
Main Methods:
- The study included 120 patients with a first, non-cardioembolic ischemic stroke.
- Data collected included traditional risk factors, blood pressure, glucose, lipids, apoA-I, apoB, homocysteine, and C-reactive protein (CRP).
- Carotid duplex ultrasound assessed intima-media thickness (cIMT) and identified unstable plaques.
Main Results:
- Carotid intima-media thickness (cIMT) was significantly associated with older age, lower apoA-I, and a higher apoB/apoA-I ratio.
- Unstable carotid plaque presence strongly correlated with elevated apoB, metabolic syndrome (MetS), and increased CRP levels.
- Specific p-values and odds ratios (OR) with confidence intervals (CI) were reported for key associations.
Conclusions:
- Apolipoprotein A-I, apoB, and the apoB/apoA-I ratio demonstrate significant associations with ultrasound markers of carotid atherosclerosis in IS patients.
- These apolipoproteins may serve as valuable biomarkers for assessing carotid atherosclerosis in the context of ischemic stroke.
- The findings highlight the role of specific apolipoproteins and biomarkers in the pathophysiology of carotid atherosclerosis related to stroke.
Background:
Apolipoproteins A-I and B (apoA-I and apoB) may be better indicators of the risk of cardiovascular and cerebrovascular diseases than conventional risk factors (RFs). The onset of ischemic stroke (IS) may be preceded by the development of atherosclerotic changes in carotid arteries, which can be detected by ultrasound. Only a certain % of patients with IS have an (underlying) carotid etiology.
Objective:
The aim of our study was to determine the association between ultrasound indicators of carotid atherosclerosis and the presence of apolipoproteins and other biomarkers in patients with IS.
Methods:
The study included 120 patients with clinically first, non-cardioembolic ischemic stroke in the carotid circulation. For all patients the following data were recorded: risk factors (hypertension, diabetes, hyperlipoproteinemia, smoking, obesity, metabolic syndrome, (MetS) hyperhomocysteinemia and inflammation), and levels of blood pressure, glucose, glycosylated hemoglobin, lipids, apoA-I and apoB apolipoproteins, body mass index, homocysteine, and C-reactive protein (CRP). Carotid duplex ultrasound was used to measure carotid intima media thickness (cIMT) and determine the presence of an unstable (hypoechogenic) plaque.
Results:
The most significant associations were found between cIMT and older age (β=0.230; p=0.006), lower concentrations of apoA-I (β=-0.244; p=0.008) and a higher apoB/apoA-I ratio (β=0.247; p=0.007). The presence of a hypoechogenic plaque was most significantly associated with increased concentrations of apoB (OR=2.29; 95% CI=4.9-173.5; p<0.0001), the presence of MetS (OR=9.2; 95% CI=2.9-29.2; p<0.0001) and elevated CRP (OR=2.7; 95% CI=1.1-6.9; p = 0.046).
Conclusion:
Among RFs and their biomarkers, apoA-I, apoB and the apoB/apoA-I ratio showed strong association with ultrasound indicators of carotid atherosclerosis in IS patients.
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