TY - JOUR
T1 - Association of lipids with ischemic and hemorrhagic stroke a prospective cohort study among 267 500 Chinese
AU - Gu, Xiaoying
AU - Li, Yunzhi
AU - Chen, Shuohua
AU - Yang, Xueli
AU - Liu, Fangchao
AU - Li, Ying
AU - Li, Jianxin
AU - Cao, Jie
AU - Liu, Xiaoqing
AU - Chen, Jichun
AU - Shen, Chong
AU - Yu, Ling
AU - Huang, Jianfeng
AU - Lam, Tai Hing
AU - Fang, Xianghua
AU - He, Yao
AU - Zhang, Xinhua
AU - Lu, Xiangfeng
AU - Wu, Shouling
AU - Gu, Dongfeng
N1 - Publisher Copyright:
© 2019 American Heart Association, Inc.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background and Purpose-Previous results on the association between lipids and stroke were controversial. We investigatedthe association of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C ), high-density lipoprotein cholesterol(HDL-C), and triglyceride with stroke.Methods-Six cohort studies in China with 267500 participants were included. Cox proportional hazards regression modelsand restricted cubic spline analyses were used to estimate hazard ratios and 95% CIs and explore linear and nonlinearrelationships of lipids and stroke, respectively.Results-The median follow-up duration ranged from 6 to 19 years. During 2 295 881 person-years, 8072 people developedstroke. Multivariable adjusted hazard ratios (95% CIs) per 1 mmol/L increase in TC, LDL-C, triglyceride were 1.08(1.05-1.11), 1.08 (1.04-1.11), 1.07 (1.05-1.09) for ischemic stroke, respectively. Compared with participants with TC160-199.9 mg/dL, hazard ratios (95% CIs) were 1.43 (1.11-1.85) for hemorrhagic stroke in those with TC <120 mg/dL. Compared with participants with HDL-C 50 to 59.9 mg/dL, hazard ratios (95% CIs) were 1.23 (1.12-1.35), 1.13(1.04-1.22) for ischemic stroke, and 1.28 (1.10-1.49), 1.17 (1.03-1.33) for hemorrhagic stroke in those with HDL-C<40 and 40 to 49.9 mg/dL, respectively. Restricted cubic spline analyses showed linear relationships of TC and LDL-C,and nonlinear relationships of HDL-C and triglyceride with ischemic stroke (all P<0.001). Hemorrhagic stroke showedlinear relationships with TC and HDL-C (P=0.029 and <0.001 respectively), but no relationship with LDL-C andtriglyceride (all P>0.05).Conclusions-TC, LDL-C, and triglyceride showed positive associations with ischemic stroke. The risk of hemorrhagicstroke was higher when TC was lower than 120 mg/dL. LDL-C and triglyceride showed no association with hemorrhagicstroke. The risks of ischemic and hemorrhagic stroke might be higher when HDL-C was lower than 50 mg/dL.
AB - Background and Purpose-Previous results on the association between lipids and stroke were controversial. We investigatedthe association of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C ), high-density lipoprotein cholesterol(HDL-C), and triglyceride with stroke.Methods-Six cohort studies in China with 267500 participants were included. Cox proportional hazards regression modelsand restricted cubic spline analyses were used to estimate hazard ratios and 95% CIs and explore linear and nonlinearrelationships of lipids and stroke, respectively.Results-The median follow-up duration ranged from 6 to 19 years. During 2 295 881 person-years, 8072 people developedstroke. Multivariable adjusted hazard ratios (95% CIs) per 1 mmol/L increase in TC, LDL-C, triglyceride were 1.08(1.05-1.11), 1.08 (1.04-1.11), 1.07 (1.05-1.09) for ischemic stroke, respectively. Compared with participants with TC160-199.9 mg/dL, hazard ratios (95% CIs) were 1.43 (1.11-1.85) for hemorrhagic stroke in those with TC <120 mg/dL. Compared with participants with HDL-C 50 to 59.9 mg/dL, hazard ratios (95% CIs) were 1.23 (1.12-1.35), 1.13(1.04-1.22) for ischemic stroke, and 1.28 (1.10-1.49), 1.17 (1.03-1.33) for hemorrhagic stroke in those with HDL-C<40 and 40 to 49.9 mg/dL, respectively. Restricted cubic spline analyses showed linear relationships of TC and LDL-C,and nonlinear relationships of HDL-C and triglyceride with ischemic stroke (all P<0.001). Hemorrhagic stroke showedlinear relationships with TC and HDL-C (P=0.029 and <0.001 respectively), but no relationship with LDL-C andtriglyceride (all P>0.05).Conclusions-TC, LDL-C, and triglyceride showed positive associations with ischemic stroke. The risk of hemorrhagicstroke was higher when TC was lower than 120 mg/dL. LDL-C and triglyceride showed no association with hemorrhagicstroke. The risks of ischemic and hemorrhagic stroke might be higher when HDL-C was lower than 50 mg/dL.
KW - Cholesterol
KW - Stroke
KW - Triglyceride
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U2 - 10.1161/STROKEAHA.119.026402
DO - 10.1161/STROKEAHA.119.026402
M3 - Article
C2 - 31658904
AN - SCOPUS:85075812970
SN - 0039-2499
VL - 50
SP - 3376
EP - 3384
JO - Stroke
JF - Stroke
IS - 12
ER -