Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women.
Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women.
Available online from MWHC library: 1970 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial. CONCLUSIONS: Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women. METHODS: We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio. RESULTS: In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13-2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10-2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04-2.04; P for trend=0.02) were significantly associated with ischemic stroke.
English
0039-2499
*Brain Ischemia/bl [Blood]
*Cholesterol/bl [Blood]
*Lipoproteins/bl [Blood]
*Postmenopause/bl [Blood]
*Stroke/bl [Blood]
Aged
Biological Markers/bl [Blood]
Brain Ischemia/ep [Epidemiology]
Case-Control Studies
Female
Humans
Incidence
Prospective Studies
Risk Factors
Stroke/ep [Epidemiology]
MedStar Health Research Institute
Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Available online from MWHC library: 1970 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial. CONCLUSIONS: Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women. METHODS: We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio. RESULTS: In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13-2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10-2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04-2.04; P for trend=0.02) were significantly associated with ischemic stroke.
English
0039-2499
*Brain Ischemia/bl [Blood]
*Cholesterol/bl [Blood]
*Lipoproteins/bl [Blood]
*Postmenopause/bl [Blood]
*Stroke/bl [Blood]
Aged
Biological Markers/bl [Blood]
Brain Ischemia/ep [Epidemiology]
Case-Control Studies
Female
Humans
Incidence
Prospective Studies
Risk Factors
Stroke/ep [Epidemiology]
MedStar Health Research Institute
Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.