Apolipoprotein A1, B levels, and their ratio and the risk of a first stroke: a meta-analysis and case–control study

Abstract

The associations of levels of apolipoprotein A1 (ApoA1) and apolipoprotein B and ApoB/A1 ratio and risk of a first stroke have not been reliably documented. We performed a meta-analysis to summarize the relationships and confirmed them in a case-control study. We identified relevant publications in PubMed and Embase databases up to June 1, 2015. A Dersimonian-Laird random effects model was used to compute summary relative risks (RRs) and 95 % confidence intervals (CIs). A case-control study was conducted in a southern Chinese population. We included 8 cohort and 4 case-control studies (222,774 subjects; 10,032 first stroke events) in the meta-analysis. Reduced ApoA1 level and increased ApoB level and ApoB/A1 ratio was associated with a first stroke in cohort studies (RR 0.86 [95 % CI 0.79-0.94], 1.66 [1.62-1.69], and 1.66 [1.63-1.70], respectively) and reduced ApoA1 level and increased ApoB/A1 ratio in case-control studies (0.68 [0.47-0.99] and 1.76 [1.50-2.06], respectively). When stratified by stroke type in cohort studies, the RR for ischemic stroke was 0.83 (0.76-0.90), 1.36 (1.32-1.40), and 1.38 (1.35-1.42) for the 3 factors, respectively. In our case-control study (1013 cases; 1029 controls), the OR for a first ischemic stroke was 0.83 (0.74-0.92), 1.33 (1.18-1.48) and 2.10 (1.76-2.51), respectively, with increased ApoA1 level associated with hemorrhagic stroke (1.37 [1.06-1.78]). Meta-analysis suggests that reduced ApoA1 level and increased ApoB level and ApoB/A1 ratio are risk factors for a first ischemic but not hemorrhagic stroke. Elevated ApoA1 level may be a risk factor for a first hemorrhagic stroke.

The correlation between serum apolipoprotein B/apolipoprotein A1 ratio and brain necrosis in patients underwent radiotherapy for nasopharyngeal carcinoma

“…Several studies have indicated an correlation of the ApoB/ApoA1 ratio and the risk of stroke (Dong et al, ; Kostapanos et al, ), intracranial and extracranial carotid stenosis (Park et al, , ). But no prior study has demonstrated a correlation between the ApoB/ApoA1 ratio and RN in patients after radiotherapy for NPC.…”

“…The ApoA1 level refers to a marker of antioxidant and anti‐inflammatory properties (Walldius & Jungner, ). While, the ApoB is a marker of oxidative and atherogenic properties (Dong et al, ). The elevated ApoB/ApoA1 ratio mirrors the unbalance of proinflammation and anti‐inflammation, which might enhance the RN.…”

“…Among traditional cardiovascular risk factors, apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) ratio is recognized to have the strongest predictive value for ischemic stroke (Kostapanos et al, ). A meta‐analysis suggests that increased ApoB/ApoA1 ratio was risk factor for a first cerebral ischemic (Dong et al, ). Jong‐Ho Park also suggested that a higher ApoB/ApoA1 ratio is a predictor of intracranial atherosclerotic stenosis in Asian patients with stroke (Park, Hong, Lee, Kim, & Song, ).…”

Association Between MspI Polymorphisms of the Apolipoprotein A-I Gene and Hyperlipidemia in an Iranian Population

“…Polymerase chain reaction (PCR) was used to amplify the fragment of 433 bp at the 5' end of the apoAI gene. To amplify the 5' end of the apoAI gene containing the polymorphic MspI sites, the following primer sequences were used: forward primer 5'-AGGGACAGAGCTGATCCTTGAACTCTTAAG-3, and reverse primer was 5'-TTAGGGGACACCTACCCGTCAGGAAGAGCA-3' (5,12). PCR was carried out in a 25 µl final volume containing 10 pmol of each primer, 50 ng genomic DNA, 2.5 µl of 10 × reaction buffer, 2 mM MgCl 2 , 0.1 mM dNTP, and 1 unit of Taq DNA polymerase.…”

“…ApoB-and apoAI-containing lipoproteins are potentially atherogenic and anti-atherogenic, respectively. The ratio between apoB/apoAI could show a balance between atherogenic and anti-atherogenic lipoproteins (11,12). ApoAI, the main apolipoprotein of HDL, is a candidate gene for dyslipidemia pathophysiology.…”