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Circulating Lipoprotein Lipids, Apolipoproteins and Ischemic Stroke.
Yuan, Shuai; Tang, Bowen; Zheng, Jie; Larsson, Susanna C.
Afiliação
  • Yuan S; Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
  • Tang B; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
  • Zheng J; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
  • Larsson SC; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Ann Neurol ; 88(6): 1229-1236, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32981134
ABSTRACT

OBJECTIVE:

We conducted a Mendelian randomization (MR) study to disentangle the comparative effects of lipids and apolipoproteins on ischemic stroke.

METHODS:

Single-nucleotide polymorphisms associated with low- and high-density lipoprotein (LDL and HDL) cholesterol, triglycerides, and apolipoprotein A-I and B (apoA-I and apoB) at the level of genomewide significance (p < 5 × 10-8 ) in the UK Biobank were used as instrumental variables. Summary-level data for ischemic stroke and its subtypes were obtained from the MEGASTROKE consortium with 514,791 individuals (60,341 ischemic stroke cases, and 454,450 non-cases).

RESULTS:

Increased levels of apoB, LDL cholesterol, and triglycerides were associated with higher risk of any ischemic stroke, large artery stroke, and small vessel stroke in the main and sensitivity univariable MR analyses. In multivariable MR analysis including apoB, LDL cholesterol, and triglycerides in the same model, apoB retained a robust effect (p < 0.05), whereas the estimate for LDL cholesterol was reversed, and that for triglycerides largely attenuated. Decreased levels of apoA-I and HDL cholesterol were robustly associated with increased risk of any ischemic stroke, large artery stroke, and small vessel stroke in all univariable MR analyses, but the association for apoA-I was attenuated to the null after mutual adjustment.

INTERPRETATION:

The present MR study reveals that apoB is the predominant trait that accounts for the etiological basis of apoB, LDL cholesterol, and triglycerides in relation to ischemic stroke, in particular large artery and small vessel stroke. Whether HDL cholesterol exerts a protective effect on ischemic stroke independent of apoA-I needs further investigation. ANN NEUROL 2020;881229-1236.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Ann Neurol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Suécia

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo prognóstico Idioma: Inglês Revista: Ann Neurol Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Suécia
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