Based On Cerebral Angiography:the Relationship Between Nontraditional Lipid Parameters And Intracranial And Extracranial Arterial Stenosis

Background:Due to the reform and open-up policy,we have achieved rapid economic development,the national living environment,work and rest habits,diet composition and mental stress have also undergone corresponding changes,resulting in a sudden rise in the incidence of cerebrovascular diseases.In accordance with the relevant research,it has been shown that the primary cause of death is stroke,including patients with ischemic stroke which accounted for nearly seventy percent of the total incidences.The high morbidity,high mortality,and high recurrence rate bring serious threat to the individuals,society,family life,health and economic costs.Most of the causes are vascular stenosis caused by atherosclerosis,where blood lipid plays an important role in the formation of atherosclerotic plaque.Therefore,clinically,patients with cerebral infarction are treated by inhibiting platelet aggregation,reducing blood lipids and stabilizing plaques,with special attention paid to the standard of LDL-C.However,there is increasing evidence that these patients still suffer from cerebral infarction despite LDL-C compliance with lipid-lowering drugs,suggesting that we need to look for lipid parameters with higher sensitivity of to guide clinical practice;In previous studies,the evaluation of intracranial and extracranial artery stenosis was only performed by cranial TCD,cervical vascular color doppler ultrasound,cranial MRA,CTA and other non-" gold standard" methods,which had certain limitations and was not as accurate as cerebral angiography.Therefore,this is to study the relationship between non-traditional lipid parameters and intracranial and extracranial artery stenosis based on cerebral angiography.Purpose:Based on the gold standard of cerebral angiography,the relationship between non-traditional blood lipid parameters and intracranial and extracranial artery stenosis was analysed,so it can be better applied it to clinical practice and play a certain role in the prevention and treatment of stroke.Method:Collect patients ’ data including gender,age,past medical history,laboratory indicators and cerebral angiography results.The above tests and results interpretation were completed by qualified physicians of the department of clinical laboratory and interventional physicians of our hospital.SPSS24.0and Medcalc20.0 were used for analysing data,and each result was marked as statistically significant when P < 0.05.Results:1.Compared with NCAS group,TC,LDL-C,Non-HDL-C,TC/HDL-C,LDL-C/HDL-C,Apo B/HDL-C were higher in CAS group,while HDL-C level was lower,and there were statistical differences.2.Compared with NCAS group,ECAS+ICAS group had significant differences in age,hypertension and diabetes mellitus,and the levels of LDL-C,TC,Non-HDL-C,TC/HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C and Apo B/HDL-C were higher.The HDL-C level was lower,and the difference was statistically significant;Compared with NCAS group,there was a significant difference in hypertension in ICAS group.Compared with NCAS group,TC/HDL-C,Non-HDL-C,Non-HDL-C/HDL-C and LDL-C/HDL-C in ICAS group and ECAS group were lower than those in NCAS group,and the HDL-C level was lower in ICAS group and ECAS group.There were statistically significant differences;3.In the adjustment the data for age,sex,smoking history,drinking history,hypertension,diabetes,Multivariate Logistic regression analysis showed that the levels of TC/HDL-C,Non-HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C,Apo B/HDL-C were still positively correlated with the risk of isolated ICAS and ECAS+ICAS group.With every 1 unit increase in TC/HDL-C,Non-HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C,Apo B/HDL-C levels,The risk of ECAS+ICAS increased by 2.331(95%CI:1.567-3.468),2.231(95%CI:1.425-3.495)times,2.331(95%CI:1.567-3.468)times,2.774(95%CI:1.698-4.531)times and 8.042(95%CI:1.907-33.905)times,respectively.After adjusting the data for age,sex,smoking history,drinking history,hypertension and diabetes,multivariate Logistic regression analysis showed that serum TC/HDL-C,non-HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C levels were still positively correlated with the risk of isolated ECAS group.With every 1 unit increase in TC/HDL-C,Non-HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C levels,the risk of ECAS increased by 2.171(95%CI:1.297-3.634),2.328(95%CI:1.179-4.597),2.171(95%CI:1.297-3.634),and 2.789(95%CI:1.358-5.729),respectively.4.ROC curve showed that within non-traditional lipid parameters,the indexes with the predictive ability for isolated ICAS were: TC/HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C,Apo B/HDL-C and Non-HDL-C,among which the largest AUC was: TC/HDL-C(or non-HDL-C /HDL-C).At the same time,LDL-C was compared with AUC of non-traditional lipid parameters,and it was found that the AUC of TC/HDL-C(Non-HDL-C/HDL-C),LDL-C/HDL-C and Non-HDL-C was larger than that of LDL-C,and there were statistical differences.ROC curve showed that within the non-traditional lipid parameters,the indexes that had the ability to predict is isolated ECAS were TC/HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C and Non-HDL-C.Among them,the largest AUC was TC/HDL-C(or non-HDL-C/HDL-C).When comparing the AUC of LDL-C with non-traditional lipid parameters,and found that the AUC of TC/HDL-C(non-HDL-C /HDL-C)and LDL-C/HDL-C were larger than that of LDL-C,and there were statistical differences.ROC curve showed that within the non-traditional lipid parameters,the indexes that had the ability to predict ECAS+ICAS were TC/HDL-C,Non-HDL-C/HDL-C,LDL-C/HDL-C,Apo B/HDL-C and Non-HDL-C.Among all the lipid parameters,the largest AUC was: TC/HDL-C(or non-HDL-C/HDL-C).At the same time,we compared the AUC of LDL-C with non-traditional lipid parameters,and found that the AUC of TC/HDL-C(non-HDL-C /HDL-C)and LDL-C/HDL-C was higher than that of LDL-C,and the AUC was statistically significant.Comparison of TC/HDL-C combined with other lipid parameters and TC/HDL-C alone for the prediction of isolated ICAS,isolated ECAS,ECAS+ICAS showed that the combined indicators could not significantly improve the prediction ability of cerebral artery stenosis.Conclusion: Non-traditional lipid parameters are associated with cerebral artery stenosis,and TC/HDL-C has the strongest predictive ability for cerebral artery stenosis.