Lipoprotein A Relationship With The Chinese Stroke Caused By Atherosclerosis Of The Mechanism

Background and Purpose — It is still inconclusive whether high plasma lipoprotein(a) [Lp(a)] level is a risk factor for stroke. Small sample size, different ethnic groups and methodology might be contributors to the conflicts. The purpose of the present study was to investigate the association between plasma Lp(a) levels, pentanucleotide TTTTA repeat (PNTR) polymorphism of apolipoprotein(a) [apo(a)] gene and Chinese stroke in a case-control study.Methods—1825 cases with stroke (44.3% cerebral atherothrombosis, 28.3% lacunar infarction, and 27.3% intracerebral hemorrhage) and 1817 controls were recruited from 7 centers in China. Lp(a) concentrations were quantified by using ELISA. The PNTR polymorphism of apo(a) gene was determined by using PCR-PAGE. Multivariate logistic regression analysis was employed to identify independent risk factors for stroke and its subtypes.Results—Lp(a) levels were significantly higher in cases than in controls (median, 28.5 vs 23.1 mg/dL, P<0.001), leading to a 1.97-fold (95%CI: 1.64-2.37) increase of risk for overall stroke , 2.0 (95% CI: 1.59-2.52) for atherothrombotic type, 2.05 (95% CI: 1.59-2.63) for lacunar type, and 1.64 (95% CI: 1.21-2.21) for hemorrhagic type. The number of PNTR negatively correlated with Lp(a) levels. Low number repeats (sum of both alleles<16) of apo(a) PNTR was associated with both atherothrombotic stroke (0R=1.41, 95% CI: 1.04-1.91) and hemorrhagic stroke (OR=1. 62, 95% CI: 1.09-2.37). Conclusions—Our results for the first time indicate that low numbers of apo(a) PNTR and plasma Lp(a) levels are independently associated with both ischemic and hemorrhagic stroke in Chinese.