The predictive value of nontraditional lipid parameters for intracranial and extracranial atherosclerotic stenosis: a hospital-based observational study in China

Abstract

Background Ischemic strokes are primarily caused by intracranial and extracranial atherosclerotic stenosis. Nontraditional lipid parameters broaden traditional lipid profiles, better reflect the metabolism and interaction between different lipid components, and optimize the predictive ability of lipid profiles for atherosclerotic diseases. This research was carried out to investigate the predictive value of nontraditional lipid parameters for intracranial or extracranial atherosclerotic stenosis. Methods The investigation collected data from inpatients who underwent cervical vascular ultrasonography, carotid CTA, cerebral artery CTA or MRA, and brain MRI or CT from December 2014 to December 2021. The nontraditional lipid parameters were calculated by collecting traditional lipid parameters. To evaluate the predictive power of nontraditional lipid parameters, logistic regression and receiver operating characteristic curve (ROC) analyses were performed. Results Based on the inclusion and exclusion criteria, 545 patients were included. According to the imaging results, inpatients were divided into two groups, including no intracranial or extracranial atherosclerotic stenosis (n = 250) and intracranial or extracranial atherosclerotic stenosis (AS, n = 295). Among them, AS was further divided into three subgroups: intracranial atherosclerotic stenosis (ICAS), extracranial atherosclerotic stenosis (ECAS) and combined intracranial and extracranial atherosclerotic stenosis (IECAS). Logistic regression analysis showed that nontraditional lipid parameters, including the atherogenic index of plasma (AIP), TG/HDL-C, remnant cholesterol (RC), nonhigh-density lipoprotein cholesterol (non-HDL-C), lipoprotein combine index (LCI), atherogenic coefficient (AC), Castelli’s index-I (CRI-I) and Castelli’s index-II (CRI-II), were significantly correlated with intracranial or extracranial atherosclerotic stenosis (P < 0.05). Compared with other nontraditional lipid parameters, regardless of adjusting for potential confounding factors, AIP had a greater OR value in ICAS (OR = 4.226, 95% CI: 1.681–10.625), ECAS (OR = 2.993, 95% CI: 1.119–8.003) and IECAS (OR = 4.502, 95% CI: 1.613–12.561). ROC curve analysis revealed that nontraditional lipid parameters had good predictive power for intracranial or extracranial atherosclerotic stenosis. Conclusions This Chinese hospital-based study demonstrates that nontraditional lipid parameters (AIP, LCI, RC, CRI-II, AC, CRI-I and non-HDL-C) are effective predictors of intracranial and extracranial atherosclerotic stenosis, of which AIP may be a significant risk factor for predicting atherosclerotic arterial stenosis in the intracranial or extracranial regions.

Association between atherogenic index of plasma and new-onset stroke in individuals with different glucose metabolism status: insights from CHARLS

“…Further investigation is warranted to determine if AIP levels can serve as a marker for Pre-DM and DM. Recent research has explored the association between AIP and cerebrovascular disease, revealing that higher AIP levels are correlated with a higher incidence of atherosclerotic stenosis in the carotid and intracranial arteries [ 10 , 32 ]. In the general population, increased baseline and cumulative AIP levels are associated with a greater risk of ischemic stroke [ 9 , 11 ].…”

“…AIP potentially serves as a significant predictor of intracranial arterial stenosis, the risk of ischemic stroke, and poor stroke outcomes. [9][10][11][12]. On the other hand, AIP serves as a reliable indicator of IR, which indicates that it may differentiate stroke risk in individuals with abnormal glucose metabolism.…”

Lipoprotein Combine Index as a Better Marker for NAFLD Identification Than Traditional Lipid Parameters

“…Previous observational studies have indicated that LCI was an independent predictor of coronary artery disease severity and progression; [20][21][22]54,55 additionally, in recent reports by Yu et al, LCI was also found to effectively predict atherosclerotic stenosis in both intracranial and extracranial arteries. 19 However, no studies have yet evaluated the association between LCI and NAFLD. In our current study, using health examination data from a general population, we compared the association of LCI and traditional lipid parameters with NAFLD and assessed their diagnostic abilities using ROC curves.…”

“…Completed studies have shown that LCI can effectively identify and predict the risk of atherosclerosis and cardiovascular diseases. [19][20][21][22] In fact, as a comprehensive indicator for lipid profile assessment, the various components of the LCI are highly correlated with NAFLD. 8,23 Compared to traditional single lipid markers, the LCI may better reflect the multidimensional lipid metabolism abnormalities associated with the development of NAFLD.…”

Association between atherogenic index of plasma and new-onset stroke in individuals with different glucose metabolism status: insights from CHARLS

“…As a robust biomarker of dyslipidemia, AIP has been considered to be a powerful independent predictor of adverse cardiovascular and cerebrovascular events. AIP is potentially served as a signi cant predictor of intracranial arterial stenosis, the risk of ischemic stroke, and poor stroke outcomes (8)(9)(10)(11). On the other hand, AIP serves as a reliable indicator of insulin resistance, which indicates that it may differentiate stroke risk in individuals with abnormal glucose metabolism.…”