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The associations of lipids and lipid ratios with stroke: A prospective cohort study

Xiaojuan Liu1, Ling Yan2, Fuzhong Xue1

  • 1Department of Biostatistics, School of Public Health, Shandong University, Jinan, China.

Journal of Clinical Hypertension (Greenwich, Conn.)
|November 22, 2018
PubMed

Insights

Lipid ratios like TC/HDL-C in men and triglycerides (TG) in women are linked to higher stroke risk. These markers can help identify individuals at high risk for stroke prevention.

Area of Science:

  • Cardiovascular epidemiology
  • Metabolic syndrome research
  • Neurology and stroke research

Background:

  • Lipids and lipid ratios are established cardiovascular disease risk factors.
  • The specific associations and predictive values of lipids for stroke subtypes remain incompletely understood.
  • Understanding these relationships is crucial for targeted stroke prevention strategies.

Purpose of the Study:

  • To investigate the association between lipids and lipid ratios with type-specific stroke (ischemic and hemorrhagic).
  • To compare the predictive capabilities of various lipid parameters for stroke occurrence.
  • To determine sex-specific differences in lipid-associated stroke risk.

Main Methods:

  • Prospective cohort study including 42,005 Chinese adults aged 20-80, free of stroke at baseline.
  • Participants were followed for an average of 3.6 years, with stroke outcomes categorized into ischemic, hemorrhagic, and total stroke.
  • Statistical analyses included multivariable-adjusted hazard ratios (HR) and receiver operating characteristic (ROC) curve analysis to assess predictive accuracy (Area Under the Curve - AUC).

Main Results:

  • In men, the highest quartile of Total Cholesterol/HDL-Cholesterol (TC/HDL-C) ratio was associated with increased risk of ischemic and total stroke (HRs 1.52 and 1.45, respectively).
  • TC/HDL-C demonstrated the highest predictive capacity for ischemic and total stroke in men (AUCs 0.868 and 0.874).
  • In women, the highest Triglyceride (TG) quartile was linked to higher ischemic and total stroke risk (HRs 1.99 and 1.85, respectively), with strong predictive values (AUCs 0.850 and 0.861).
  • No significant associations were found between lipid variables and hemorrhagic stroke in either sex.

Conclusions:

  • The TC/HDL-C ratio is a valuable predictor of stroke risk in men.
  • Triglycerides (TG) are a more significant predictor of stroke risk in women.
  • These lipid parameters can aid in identifying high-risk individuals for targeted stroke prevention efforts.

Keywords:
coronary diseaseepidemiologylipidsstroke and stroke prevention

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