Association between lipoprotein(a) concentration and the risk of stroke in the Chinese Han population: a retrospective case-control study

Abstract

Background: Lipoprotein(a) [Lp(a)] is a risk factor of coronary heart disease, however, its effects on stroke are less well-defined.Methods: We performed a single-center, retrospective case-control study in 1,953 and 196 ischemic stroke and hemorrhagic stroke in-hospital patients, respectively. Controls were healthy individuals that were matched for sex and age (±5 years) for the ischemic (1:1 ratio) and hemorrhagic (1:2 ratio) stroke. Lp(a) concentration was measured using the latex agglutination turbidimetric method. Logarithmic transformation and quartile categorization were applied to adjust for the skewed distribution of Lp(a). Conditional logistic regression models were used to assess the association between Lp(a) and stroke risk.Results: Median Lp(a) concentration was higher in stroke patients when compared with controls (12.2 vs. 8.60 mg/dL) and hemorrhagic strokes (14.40 vs. 13.40 mg/dL). The conditional multivariate analysis revealed a positive association between Lp(a) and ischemic stroke (OR =2.03, 2.36, and 2.03 for quartiles 2, 3 and 4, respectively, vs. quartile 1; P<0.001). In addition, elevated Lp(a) was also significantly associated with increased hemorrhagic stroke risk, after adjusted for potential covariates (OR =1.93, 3.24, and 2.19 for quartile 2, 3 and 4 respectively vs. quartile 1, P<0.05). The stratified analyses for ischemic and hemorrhagic stroke revealed significant association between elevated log-transformed Lp(a) and ischemic stroke in men.Furthermore, there was a trend towards a higher stroke risk for younger patients compared with older patients.Conclusions: Elevated serum Lp(a) is significantly positively correlated with ischemic and hemorrhagic stroke risk in the Chinese Han population, especially among men and younger patients.

Taohong Siwu Decoction Ameliorates Ischemic Stroke Injury Via Suppressing Pyroptosis

“…However, stroke was an important cause of death and disability at present. The prevalence rate continues to increased, and the affected population has shown a younger trend (Fu et al, 2020). Therefore, the prevention and treatment of stroke was a very serious problem in China.…”

Lipoprotein (a) level as a risk factor for stroke and its subtype: A systematic review and meta-analysis

“… Christopher et al, 1996 37 Asian Case–control study HB 50/50 27 ± 5 27 ± 5 Age, sex and socioeconomic status ELISA NA NA NA 5 6. Fu et al, 2020 38 Asian Case–control study HB 1953/1953 62.3 ± 11.8 59.9 ± 11.1 Age and sex Latex agglutination turbidimetric method 23.2 mg/dl NA NA 7 7. Dhamija et al, 2009 39 Asian Case–control study HB 66/72 54.43 ± 13 54.4 ± 13 Age and sex Immunoturbidimetric immunoassay ≤ 30 mg/dl Within 12 h NA 6 8.…”

“… Author name and year Ethnicity Study design Sample size (ICH/control) ICH age, years Control age, years Source of control Matching criteria LPA assay method LPA cut -off value LPA assay timepoint Follow up duration NOS quality score 1. Fu et al, 2020 38 Asian Case–control study 196/392 57.9 ± 13.7 57.9 ± 13.7 HB Age and sex Latex agglutination turbidimetric method 23.2 mg/dl NA NA 7 2. Sun et al, 2003 45 Asian Case–control study 499/1817 58.2 ± 9.7 59.6 ± 8.5 PB NA ELISA Within 6 weeks NA NA 7 3.…”

“…No information was available for the stroke patients undergoing any LPA treatments in all the included studies in our meta-analysis. Only 11 studies 21 , 35 , 38 , 40 – 42 , 44 , 45 , 52 , 54 , 55 reported calculated OR with 95% CI for the association of Lp (a) with the risk of IS as compared to control subjects; which have been used directly for estimating pooled ORs with 95% CI.…”

Association of Lipoprotein (a) variants with risk of cardiovascular disease: a Mendelian randomization study

“…Gudbjartsson DF and colleagues found that the odds ratio of 1.03 (95%CI: 1.00–1.07) for stroke for a 50 nmol/L increase in Lp(a) lost significance when KIV-2 repeats were used (OR: 1.01; 95%CI: 0.98–1.04) [ 27 ]. A recent retrospective case-control study indicated that elevated Lp(a) was significantly associated with increased ischemic stroke risk (OR = 2.03, 2.36, and 2.03 for quartiles 2, 3 and 4, respectively, vs. quartile 1) in Han Chinese individuals, especially among men and younger patients [ 31 ]. Some of the factors may have contributed to the differential findings among the present study and previous studies.…”