The Predictive Value Of Nontraditional Lipid Parameters For Intracranial And Extracranial Atherosclerotic Stenosis

Background and objective: Ischemic strokes are primarily caused by intracranial and extracranial atherosclerotic stenosis.Traditional lipid parameters include low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglycerides(TG)and high-density lipoprotein cholesterol(HDL-C).Unlike traditional individual lipid parameters,nontraditional lipid parameters are calculated from two or more traditional lipid parameters.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: This study collected data from inpatients who underwent cervical vascular ultrasonography and carotid CT angiography(CTA),cerebral arterial CTA or magnetic resonance angiography(MRA),computed tomography(CT)or magnetic resonance imaging(MRI)at the Affiliated Hospital of Qingdao University from December 2014 to December 2021 and met the inclusion and exclusion criteria.The patients were divided into groups by comprehensive imaging results.Clinical data of inpatients were collected,such as age,sex,body mass index(BMI),history of hypertension,smoking,ischemic stroke,diabetes mellitus,coronary heart disease,fasting blood glucose,LDL-C,TC,TG and HDL-C.Several nontraditional lipid parameters were calculated according to traditional lipid parameters(LDL-C,TC,TG and HDL-C)in different patients,including plasma atherogenic index of plasma(AIP),nonhigh-density lipoprotein cholesterol(non-HDL-C),atherogenic coefficient(AC),Castelli’s risk index-I(CRI-I),lipoprotein association index(LCI),and residual cholesterol(RC).Logistic regression and receiver operating characteristic(ROC)curve analysis were used to assess the predictive value of nontraditional lipid parameters for intracranial and extracranial atherosclerotic stenosis.Results: Based on the inclusion and exclusion criteria,545 inpatients were finally included in this investigation.According to various imaging findings,the patients were divided into two groups,including no intracranial or extracranial artery stenosis group(n= 250)and intracranial or extracranial artery stenosis group(n = 295).Among them,intracranial or extracranial artery stenosis group was further divided into intracranial artery stenosis group,extracranial artery stenosis group and combined intracranial and extracranial artery stenosis group.Logistic regression analysis showed that AIP,non-HDL-C,AC,CRI-I,CRI-II,LCI and RC were significantly associated with intracranial and extracranial arterial stenosis(P < 0.05).Compared with other lipid parameters,AIP had a greater OR in intracranial artery stenosis group(Model 3: OR =4.226,95% CI: 1.681-10.625,P = 0.002),extracranial artery stenosis group(Model 3: OR= 2.993,95% CI: 1.119-8.003,P = 0.029),and combined intracranial and extracranial artery stenosis group(Model 3: OR = 4.502,95% CI: 1.613-12.561,P = 0.004)regardless of adjusting for potential confounding covariates.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.