Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women

Jeffrey S. Berger, Aileen P. McGinn, Barbara V. Howard, Lewis Kuller, Joann E. Manson, Jim Otvos, J. David Curb, Charles B. Eaton, Robert C. Kaplan, John K. Lynch, Daniel M. Rosenbaum, Sylvia Wassertheil-Smoller

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background-Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial. Methods-We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio. Results-In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13-2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10-2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04-2.04; P for trend=0.02) were significantly associated with ischemic stroke. Conclusions-Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women.

Original languageEnglish (US)
Pages (from-to)958-966
Number of pages9
JournalStroke
Volume43
Issue number4
DOIs
StatePublished - Apr 2012

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Lipoproteins
Biomarkers
Stroke
IDL Lipoproteins
Lipids
VLDL Lipoproteins
HDL Cholesterol
Lipoprotein(a)
Odds Ratio
Confidence Intervals
Particle Size
LDL Cholesterol
Triglycerides
Cholesterol
Women's Health
HDL Lipoproteins
LDL Lipoproteins
Observational Studies
Case-Control Studies
Fasting

Keywords

  • ischemic stroke
  • lipids
  • lipoproteins
  • triglycerides
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Berger, J. S., McGinn, A. P., Howard, B. V., Kuller, L., Manson, J. E., Otvos, J., ... Wassertheil-Smoller, S. (2012). Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women. Stroke, 43(4), 958-966. https://doi.org/10.1161/STROKEAHA.111.641324

Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women. / Berger, Jeffrey S.; McGinn, Aileen P.; Howard, Barbara V.; Kuller, Lewis; Manson, Joann E.; Otvos, Jim; Curb, J. David; Eaton, Charles B.; Kaplan, Robert C.; Lynch, John K.; Rosenbaum, Daniel M.; Wassertheil-Smoller, Sylvia.

In: Stroke, Vol. 43, No. 4, 04.2012, p. 958-966.

Research output: Contribution to journalArticle

Berger, JS, McGinn, AP, Howard, BV, Kuller, L, Manson, JE, Otvos, J, Curb, JD, Eaton, CB, Kaplan, RC, Lynch, JK, Rosenbaum, DM & Wassertheil-Smoller, S 2012, 'Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women', Stroke, vol. 43, no. 4, pp. 958-966. https://doi.org/10.1161/STROKEAHA.111.641324
Berger, Jeffrey S. ; McGinn, Aileen P. ; Howard, Barbara V. ; Kuller, Lewis ; Manson, Joann E. ; Otvos, Jim ; Curb, J. David ; Eaton, Charles B. ; Kaplan, Robert C. ; Lynch, John K. ; Rosenbaum, Daniel M. ; Wassertheil-Smoller, Sylvia. / Lipid and lipoprotein biomarkers and the risk of ischemic stroke in postmenopausal women. In: Stroke. 2012 ; Vol. 43, No. 4. pp. 958-966.
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AU - Otvos, Jim

AU - Curb, J. David

AU - Eaton, Charles B.

AU - Kaplan, Robert C.

AU - Lynch, John K.

AU - Rosenbaum, Daniel M.

AU - Wassertheil-Smoller, Sylvia

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N2 - Background-Few studies simultaneously investigated lipids and lipoprotein biomarkers as predictors of ischemic stroke. The value of these biomarkers as independent predictors of ischemic stroke remains controversial. Methods-We conducted a prospective nested case-control study among postmenopausal women from the Women's Health Initiative Observational Study to assess the relationship between fasting lipids (total cholesterol, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides), lipoproteins (LDL, HDL, and very low-density lipoprotein [VLDL] particle number and size, intermediate-density lipoprotein [IDL] particle number, and lipoprotein (a)), and risk of ischemic stroke. Among women free of stroke at baseline, 774 ischemic stroke patients were matched according to age and race to control subjects, using a 1:1 ratio. Results-In bivariate analysis, baseline triglycerides (P<0.001), IDL particles (P<0.01), LDL particles (P<0.01), VLDL triglyceride (P<0.001), VLDL particles (P<0.01), VLDL size (P<0.001), LDL size (P=0.03), and total/HDL cholesterol ratio (P<0.01) were significantly higher among women with incident ischemic stroke, whereas levels of HDL-C (P<0.01) and HDL size (P<0.01) were lower. No significant baseline difference for total cholesterol (P=0.15), LDL-C (P=0.47), and lipoprotein (a) (P=0.11) was observed. In multivariable analysis, triglycerides (odds ratio for the highest versus lowest quartile, 1.56; 95% confidence interval, 1.13-2.17; P for trend=0.02), VLDL size (odds ratio, 1.59; 95% confidence interval, 1.10-2.28; P for trend=0.03), and IDL particle number (odds ratio, 1.46; 95% confidence interval, 1.04-2.04; P for trend=0.02) were significantly associated with ischemic stroke. Conclusions-Among a panel of lipid and lipoprotein biomarkers, baseline triglycerides, VLDL size, and IDL particle number were significantly associated with incident ischemic stroke in postmenopausal women.

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