Hypertriglyceridemia and Ischemic Stroke

Abstract

There are no conclusive data regarding the association between dyslipidemia and the risk of ischemic stroke (IS). Clinical investigations have primarily focused on the association between elevated levels of low-density lipoprotein cholesterol and low levels of high-density lipoprotein cholesterol as stroke risk factors. Much less scientific attention has been aimed at elevated levels of triglycerides. Consequently the potential role of hypertriglyceridemia as an independent risk factor for IS remains controversial. However, accumulating evidence has shown that hypertriglyceridemia is associated with pathophysiological processes such as endothelial dysfunction, atherosclerosis and the production of a prothrombotic state, which could contribute to IS risk. The aim of this review is to critically analyze the contribution of hypertriglyceridemia to the occurrence of IS.

Hypertriglyceridemia as a possible predictor of early neurological deterioration in acute lacunar stroke

“…Furthermore, it seems likely that treatment of hypertriglyceridemia may reduce the risk of ischemic stroke [14,15]. Various mechanisms of hypertriglyceridemia promoting atherosclerosis and thrombogenecity including endothelial dysfunction, oxidative stress, impaired endothelium-derived vasodilation, increased blood viscosity and fibrinogen level have been suggested [16]. However, the impact of hypertriglyceridemia in acute stroke is not well defined.…”

“…Microcirculatory disturbances may be another plausible mechanism [18]. Therefore, even though there are still some debates, we can postulate that hypertriglyceridemia could induce prothrombotic state, and eventually disturb microcirculation, especially for the vulnerable small-caliber penetrating arteries [16]. Finally, it could lead to extension of infarct or acceleration of neuronal death.…”

Diagnostic Criteria for Dyslipidemia

“…Moreover, many reports have also shown that hypertriglyceridemia is a risk factor for cerebral infarction, although this association is weaker than that observed for CAD 39,41,[47][48][49] . Considering these findings, these guidelines define a TG level of ≥ 150 mg/dL as the cutoff value for screening for hypertriglyceridemia; however, hypertriglyceridemia often reflects other pathological conditions, such as increased levels of • If the TG level is ≥ 400 mg/dL or non-fasting blood is used, the non HDL-C (TC−HDL-C) level should be used.…”

Apolipoprotein A5 Gene Promoter Region<b><i>-1131T/C</i></b> Polymorphism Is Associated with Risk of Ischemic Stroke and Elevated Triglyceride Levels: A Meta-Analysis

“…Although environmental and clinical risk factors (such as hypertension, diabetes mellitus, hyperlipemia, atherosclerosis, smoking, excessive alcohol drinking, and so on) are considered important [3,4], nowadays a growing spectrum of genetic susceptibility factors have been identified [5,6]. With the help of robust genome-wide association studies, the biological plausibility and epidemiological evidence suggest that the elevated triglyceride (TG) level potentially contributes to an increased risk for ischemic stroke [7,8,9]. …”