Influence of cholesterol on survival after stroke: retrospective study

Abstract

Objective: To study the comparative importance of environment and genes in the development of islet cell autoimmunity associated with insulin dependent diabetes mellitus. Design: Population based study of diabetic twins. Setting: Danish population. Subjects: 18 monozygotic and 36 dizygotic twin pairs with one or both partners having insulin dependent diabetes. Main outcome measures: Presence of islet cell antibodies, insulin autoantibodies, and autoantibodies to glutamic acid decarboxylase (GAD65) in serum samples from twin pairs 10 years (range 0-30 years) and 9.5 years (2-30 years) after onset of disease. Results: In those with diabetes the prevalence of islet cell antibodies, insulin autoantibodies, and autoantibodies to glutamic acid decarboxylase in the 26 monozygotic twins was 38%, 85%, and 92%, respectively, and in the dizygotic twins was 57%, 70%, and 57%, respectively. In those without diabetes the proportions were 20%, 50%, and 40% in the 10 monozygotic twins and 26%, 49%, and 40% in the 35 dizygotic twins. Conclusion: There is no difference between the prevalence of islet cell autoantibodies in dizygotic and monozygotic twins without diabetes, suggesting that islet cell autoimmunity is environmentally rather than genetically determined. Furthermore, the prevalence of islet cell antibodies was higher in the non-diabetic twins than in other first degree relatives of patients with insulin dependent diabetes. This implies that the prenatal or early postnatal period during which twins are exposed to the same environment, in contrast with that experienced by first degree relatives, is of aetiological importance.

Statins and Stroke

“…For example, the Lausanne Stroke Registry demonstrated that stroke patients with higher cholesterol levels had better outcomes after 1 month (Vauthey et al, 2000). In agreement with this, a retrospective study performed by Dyker et al (1997) found more patients dead or disabled after stroke with low cholesterol levels at stroke onset (Dyker et al, 1997). Taken together, there are many open questions regarding the relationship between cholesterol and stroke.…”

Serum Uric Acid as an Independent Predictor of Early Death After Acute Stroke

“…72 However, in the acute stroke setting, several studies have shown the opposite; that is, low cholesterol levels are associated with short-term mortality or worse functional outcome in patients with ischemic stroke, particularly in those who are older. [73][74][75] Several pos-sible explanations have been proposed to explain this apparent paradox, mainly the idea of selective mortality, which is a hypothesis that many individuals with high levels of total cholesterol might experience an earlier onset of severe coronary heart disease, leading to disproportionately greater mortality before reaching an advanced age. [76][77][78] It has also been argued that low cholesterol levels may reflect an underlying serious disease or poor nutritional status, which could predispose to a poor outcome after stroke.…”

Serum Cholesterol LDL and 90-Day Mortality in Patients With Intracerebral Hemorrhage

“…3 Moreover, low TCh and triglycerides in the first hours after ICH are strong independent predictors of in-hospital mortality, 4 and surprisingly higher cholesterol levels have been associated with better short-term outcomes after acute strokes, independently of subtype, vascular territory, age, and glycemia. 5,7 Studies have reported a U-shaped relation between TCh and mortality from all causes. 8 Indeed, TCh tends to decrease among old persons, probably related to a poor health, confounding the association TCh and long-term mortality.…”