Stroke, Vol 23, 1556-1562, Copyright © 1992 by American Heart Association
J Pedro-Botet, M Senti, X Nogues, J Rubies-Prat, J Roquer, L D'Olhaberriague and J Olive
BACKGROUND AND PURPOSE: The role of lipoprotein abnormalities in the
development of ischemic cerebrovascular disease has not been sufficiently
clarified. The aim of this study was to identify the lipoprotein profile in
ischemic cerebrovascular disease and the possible role of apolipoprotein E
polymorphism. METHODS: The relation between the concentrations of
lipoprotein(a), intermediate density lipoproteins, apolipoprotein A-I,
apolipoprotein B, apolipoprotein E, and other lipoproteins was studied in
100 men with ischemic cerebrovascular disease (48 atherothrombotic, 28
lacunar, and 24 of unknown type) and in 100 healthy age-matched men as a
control group. RESULTS: Patients with ischemic cerebrovascular disease had
significantly higher levels of lipoprotein(a), lipids carried by
intermediate density lipoproteins, and low density lipoprotein cholesterol
and lower levels of high density lipoproteins than control subjects.
Patients with atherothrombotic infarction had higher total serum
cholesterol and low density lipoprotein cholesterol concentrations than
patients with lacunar infarction. To assess lipoprotein abnormalities in
normolipidemic subjects, a subgroup of 38 patients with ischemic
cerebrovascular disease and 53 control subjects, both with serum
cholesterol levels < 5.2 mmol/l (200 mg/dl) and triglycerides < 2.3
mmol/l (200 mg/dl), was analyzed. Serum lipoprotein(a), lipids carried by
very low density lipoproteins and intermediate density lipoproteins, and
low density lipoprotein triglycerides were significantly higher in
normolipidemic patients compared with normolipidemic control subjects,
whereas high density lipoprotein cholesterol levels were lower.
Apolipoprotein E polymorphism in our ischemic cerebrovascular patients
differed from that of the control group, with the epsilon 4 allele being
more prevalent. CONCLUSIONS: Increased serum lipoprotein(a) levels and
intermediate density lipoprotein abnormalities together with decreased high
density lipoprotein levels are major risk factors for ischemic
cerebrovascular disease, even in normocholesterolemic and
normotriglyceridemic subjects. Finally, the epsilon 4 allele could probably
be a predisposing genetic marker for ischemic cerebrovascular disease.
ARTICLES
Lipoprotein and apolipoprotein profile in men with ischemic stroke. Role of lipoprotein(a), triglyceride-rich lipoproteins, and apolipoprotein E polymorphism
Department of Medicine, Hospital del Mar, Barcelona, Spain.
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