Association between Non-High-Density-Lipoprotein-Cholesterol Levels and the Prevalence of Asymptomatic Intracranial Arterial Stenosis

Objective: The aim of this study was to assess the association between non-high-density-lipoprotein-cholesterol (non-HDLC) and the prevalence of asymptomatic intracranial arterial stenosis (ICAS). Methods and Results: The Asymptomatic Polyvascular Abnormalities Community (APAC) study is a prospective cohort study based on the Kailuan district (China) population. A total of 5351 eligible subjects, aged $40, and without history of stroke or myocardial infarction, were enrolled in this study. Transcranial Doppler Ultrasonography (TCD) was performed on all enrolled subjects for the evaluation of ICAS presence. Out of 5351 patients, 698 subjects showed evidence of ICAS (prevalence of 13.04%). Multivariate analysis showed that non-HDL-C is an independent indicator for the presence of ICAS (OR = 1.15, 95%CI: 1.08 – 1.23), but with a gender difference (P for interaction,0.01): in men, non-HDL-C is an independent indicator for ICAS (multivariate-adjusted OR = 1.28, 95%CI: 1.18–1.39), but not in women (multivariate-adjusted OR = 1.03, 95%CI: 0.93–1.14). Subjects were divided into five subgroups based non-HDL-C levels and these levels correlated linearly with the prevalence of ICAS (P for trend ,0.01). Compared with the first quintile, multivariate-adjusted OR (95%CI) of the second, third, fourth and fifth quintiles were: 1.05 (0.71–1.56), 1.33 (0.91–1.95), 1.83 (1.27–2.63), 2.48 (1.72–3.57), respectively. Conclusion: Non-HDL-C is an independent predictor of ICAS prevalence in men but not in women, suggesting that nonHDL-C levels could be used as a surveillance factor in the primary prevention of ischemic stroke, especially in men. Citation: Wu J, Zhang Q, Yang H, Gao X, Zhou Y, et al. (2013) Association between Non-High-Density-Lipoprotein-Cholesterol Levels and the Prevalence of Asymptomatic Intracranial Arterial Stenosis. PLoS ONE 8(5): e65229. doi:10.1371/journal.pone.0065229 Editor: Stefan Kiechl, Innsbruck Medical University, Austria Received September 27, 2012; Accepted April 24, 2013; Published May 29, 2013 Copyright: 2013 Wu et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work is supported by grants from the Ministry of Science and Technology and the Ministry of Health of the People’s Republic of China (No. 2008BAI52B03). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: [email protected] (XZ); [email protected] (SW) . These authors contributed equally to this work.