Triglyceride-Related Parameters and Symptomatic Atherosclerotic Lesions in Patients With Ischemic Stroke
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Objective Recently, evidence has suggested that the pathophysiology and risk factors of intracranial atherosclerosis (ICAS) differs from those of extracranial atherosclerosis (ECAS). In addition, novel parameters reflecting metabolic conditions, such as insulin resistance or atherogenic dyslipidemia, based on triglycerides (TG) and other biomarkers, have emerged. In this study, we evaluated the association between TG-related parameters and symptomatic cerebral atherosclerosis in patients with acute ischemic stroke resulting from large artery atherosclerosis (LAA). Methods We assessed consecutive acute LAA-stroke patients between January 2010 and December 2020. Based on the radiological findings, we classified the relevant symptomatic arteries that caused the index stroke into LAA-ICAS and LAA-ECAS. As TG-related parameters, the atherogenic index of plasma (AIP) and TG-glucose (TyG) index were calculated according to the following formulas: AIP = log10 (TG Level/High-density Lipoprotein Cholesterol Level), TyG Index = Ln (TG Level × Glucose Level/2). Results A total of 519 patients with LAA-stroke were evaluated. In multivariable logistic regression analysis to identify predictors of LAA-ICAS, AIP was significantly associated with LAA-ICAS (adjusted odds ratio [aOR], 3.60; 95% confidence interval [CI], 1.60–8.06). TyG index also showed a statistically significant relationship with LAA-ICAS (aOR, 1.60; 95% CI, 1.11–2.32). However, TG per se did not show a statistical association with LAA-ECAS. Conclusion TG-related parameters were more closely associated with stroke by ICAS than by ECAS. The metabolic conditions reflected by the AIP or TyG index, rather than hypertriglyceridemia itself, may play a greater role in determining the relevant vessel causally involved in a stroke.
Abstract
Objective Recently, evidence has suggested that the pathophysiology and risk factors of intracranial atherosclerosis (ICAS) differs from those of extracranial atherosclerosis (ECAS). In addition, novel parameters reflecting metabolic conditions, such as insulin resistance or atherogenic dyslipidemia, based on triglycerides (TG) and other biomarkers, have emerged. In this study, we evaluated the association between TG-related parameters and symptomatic cerebral atherosclerosis in patients with acute ischemic stroke resulting from large artery atherosclerosis (LAA). Methods We assessed consecutive acute LAA-stroke patients between January 2010 and December 2020. Based on the radiological findings, we classified the relevant symptomatic arteries that caused the index stroke into LAA-ICAS and LAA-ECAS. As TG-related parameters, the atherogenic index of plasma (AIP) and TG-glucose (TyG) index were calculated according to the following formulas: AIP = log10 (TG Level/High-density Lipoprotein Cholesterol Level), TyG Index = Ln (TG Level × Glucose Level/2). Results A total of 519 patients with LAA-stroke were evaluated. In multivariable logistic regression analysis to identify predictors of LAA-ICAS, AIP was significantly associated with LAA-ICAS (adjusted odds ratio [aOR], 3.60; 95% confidence interval [CI], 1.60–8.06). TyG index also showed a statistically significant relationship with LAA-ICAS (aOR, 1.60; 95% CI, 1.11–2.32). However, TG per se did not show a statistical association with LAA-ECAS. Conclusion TG-related parameters were more closely associated with stroke by ICAS than by ECAS. The metabolic conditions reflected by the AIP or TyG index, rather than hypertriglyceridemia itself, may play a greater role in determining the relevant vessel causally involved in a stroke.
참고문헌 (31)
- Ritz K, "Cause and mechanisms of intracranial atherosclerosis", Circulation, 130, pp.1407~1414 (2014)
- Kim JS, "Research on intracranial atherosclerosis from the East and west : why are the results different?", J Stroke, 16, pp.105~113 (2014)
- Hoshino T, "Prognostic role of hypertriglyceridemia in patients with stroke of atherothrombotic origin", Neurology, 98, pp.e1660~ (2022)
- Libby P, "The changing landscape of atherosclerosis", Nature, 592, pp.524~533 (2021)
- Arnett DK, "2019 ACC", AHA guideline on the primary prevention of cardiovascular disease : executive summary : a report of the American College of Cardiology, Circulation, pp.2019, 140[DOI]
- Hoshino T, "Atherogenic dyslipidemia and residual vascular risk after stroke or transient ischemic attack", Stroke, 53, pp.79~86 (2022)
- Woo MH, "Triglyceride", HDL-cholesterol ratio as an index of intracranial atherosclerosis in nonstroke individuals, 2021, pp.11, 504219~
- Liang HJ, "Hypertriglyceridemia : a neglected risk factor for ischemic stroke?", J Stroke, 24, pp.21~40 (2022)
- Kang K, "The triglyceride : high-density lipoprotein-cholesterol ratio and steno-occlusive disease in the intracranial arteries", J Thromb Thrombolysis, 32, pp.103~109 (2011)
- Dobiásová M, "The plasma parameter log(TG", HDL-C)as an atherogenic index : correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma(FER(HDL)), 2001, pp.34, 583~588
- Simental-Mendía LE, "The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects", Metab Syndr Relat Disord, 6, pp.299~304 (2008)
- Yu S, "The predictive value of nontraditional lipid parameters for intracranial and extracranial atherosclerotic stenosis : a hospital-based observational study in China", Lipids Health Dis, 22, pp.16~ (2023)
- Jiang M, "Association between the triglyceride-glucose index and the risk of large artery atherosclerotic stroke", Int J Clin Pract, 2022, pp.5191581~ (2022)
- Wang M, "Association between triglyceride glucose index and atherosclerotic plaques and burden : findings from a community-based study", Cardiovasc Diabetol, 21, pp.204~ (2022)
- Yan F, "Association between triglyceride glucose index and risk of cerebrovascular disease : systematic review and meta-analysis", Cardiovasc Diabetol, 21, pp.226~ (2022)
- Yu H, "Association between triglyceride-glucose index trajectories and carotid atherosclerosis progression", Cardiovasc Diabetol, 22, pp.130~ (2023)
- Hoshino T, "Triglyceride-glucose index as a prognostic marker after ischemic stroke or transient ischemic attack : a prospective observational study", Cardiovasc Diabetol, 21, pp.264~ (2022)
- Bang OY, "Intracranial atherosclerotic stroke : specific focus on the metabolic syndrome and inflammation", Curr Atheroscler Rep, 8, pp.330~336 (2006)
- Bang OY, "Intracranial atherosclerosis : current understanding and perspectives", J Stroke, 16, pp.27~35 (2014)
- Park JH, "Metabolic syndrome is more associated with intracranial atherosclerosis than extracranial atherosclerosis", Eur J Neurol, 14, pp.379~386 (2007)
- Adams HP Jr, "Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment", Stroke, 24, pp.35~41 (1993)
- Nam KW, "High triglyceride-glucose index is associated with early recurrent ischemic lesion in acute ischemic stroke", Sci Rep, 11, pp.15335~ (2021)
- Zhang N, "Association of triglyceride-glucose index and high-sensitivity C-reactive protein with asymptomatic intracranial arterial stenosis : a cross-sectional study", Nutr Metab Cardiovasc Dis, 31, pp.3103~3110 (2021)
- Grundy SM, "Small LDL, atherogenic dyslipidemia, and the metabolic syndrome", Circulation, 95, pp.1~4 (1997)
- Reaven GM, "Banting lecture 1988. Role of insulin resistance in human disease", Diabetes, 37, pp.1595~1607 (1988)
- Park HY, "Correlation between insulin resistance and intracranial atherosclerosis in patients with ischemic stroke without diabetes", J Stroke Cerebrovasc Dis, 17, pp.401~405 (2008)
- Liang CP, "The macrophage at the crossroads of insulin resistance and atherosclerosis", Circ Res, 100, pp.1546~1555 (2007)
- Wang J, "Elevated fasting glucose as a potential predictor for asymptomatic cerebral artery stenosis : a cross-sectional study in Chinese adults", Atherosclerosis, 237, pp.661~665 (2014)
- Ding S, "The role of carotid plaque vulnerability and inflammation in the pathogenesis of acute ischemic stroke", Am J Med Sci, 336, pp.27~31 (2008)
- Lee PH, "Infarct patterns in atherosclerotic middle cerebral artery versus internal carotid artery disease", Neurology, 62, pp.1291~1296 (2004)
- Gutierrez J, "Determinants and outcomes of asymptomatic intracranial atherosclerotic stenosis", J Am Coll Cardiol, 78, pp.562~571 (2021)