Correlation Between Serum Lipoprotein(a) Level And Carotid Artery Atherosclerosis In Young And Middle-aged Patients With Ischemic Stroke: A Retrospective Case Series Study

Objective To investigate the risk factors for carotid artery atherosclerosis in youngand middle-aged patients with ischemic stroke and the effect of serum lipoprotein(a)［Lp(a)］level on the young and middle-aged patients with ischemic stroke.Methods Patients with ischemic stroke between the age of18to55wereenrolled.Carotid artery ultrasonography was used to evaluate the degree of carotidartery atherosclerosis, and the concentrations of serum total cholesterol, triglycerides,high density lipoprotein cholesterol, low density lipoprotein cholesterol, very lowdensity lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B and Lp(a) weredetected. According to the results of carotid ultrasound,the patients were dividedinto groups of without atherosclerosis, plaque without stenosis, and carotid arterystenosis. The demographic data and clinical features were compared among the3groups. Multivariate logistic regression analysis was used to identify the independentrisk factors for carotid artery atherosclerosis in young and middle-aged patients withischemic stroke.Results A total of106patients with ischemic stroke (n=50in the withoutatherosclerosis group, n=44in the plaque without stenosis group, n=12in the carotidartery stenosis group) were enrolled in the study. The constituent ratios of age（45.98±7.12,50.07±4.79and50.92±1.83years, respectively；F=7.169，P=0.001）,hypertension（26.0%,47.7%and58.3%, respectively；X2=6.862，P=0.032）,diabetes mellitus（22.0%,45.5%and66.7%, respectively；X2=10.729，P=0.005）, hyperlipidemia（24.0%,40.1%and75.0%, respectively；X2=11.372，P=0.003）and smoking （34.0%,61.4%and75.%, respectively；X2=10.393，P=0.006）,as well as the serum high-density lipoprotein cholestero（l1.03±0.26,0.95±0.26and0.76±0.08mmol/L, respectively；F=5.882，P=0.004）and Lp(a)（0.108±0.044,0.155±0.028and0.200±0.011g/L, respectively; F=41.556，P=0.000）levels hadsignificant differences in the3groups. Multivariate logistic regression analysis showedthat age>48years (plaque without stenosis： odds ratio,[OR]2.89，95%confidence interval,[CI]1.20-6.96,P=0.018；carotid artery stenosis：OR4.43，95%CI1.19-16.57,P=0.027)，hypertension（plaque without stenosis： OR2.60，95%CI1.09–6.18,P=0.031； carotid artery stenosis： OR3.99，95%CI1.08–14.77,P=0.039)，diabetes （plaque without stenosis： OR2.96，95%CI1.21–7.23,P=0.018；carotid artery stenosis：OR7.09，95%CI1.79–28.02,P=0.005)，hyperlipidemia （plaque without stenosis： OR2.19，95%CI0.91–5.31,P=0.082；carotid artery stenosis：OR9.50，95%CI2.21–40.86,P=0.002), smoking（plaquewithout stenosis： OR3.08，95%CI1.33–7.16,P=0.009；carotid artery stenosis：OR5.82，95%CI1.39–24.38,P=0.016) and Lp(a)（plaque without stenosis： OR4.38，95%CI1.76–10.90,P=0.001；carotid artery stenosis：OR12.80，95%CI2.73–52.67,P=0.005) were the independent risk factors for carotid artery atherosclerosis inyoung and middle-aged patients with ischemic stroke.Conclusions Age, smoking, hypertension, diabetes and Lp(a) were the independentrisk factors for carotid artery atherosclerosis in young and middle-aged patients withischemic stroke.