Inverse Association between High-Density Lipoprotein Cholesterol and Adverse Outcomes among Acute Ischemic Stroke Patients with Diabetes Mellitus
第一作者:Guoliang Hu
2021-12-20
Low level of high-density lipoprotein cholesterol (HDL-C) is a well-established risk factor for cardiovascular diseases. Previous studies found a strong inverse association of HDL-C with worse outcomes. Experimental studies have found that the functionality of HDL may be lost in the diabetes mellitus (DM) state. A dose–response association between high HDL-C concentrations and high CVD risk was observed in participants with DM. However, few studies have assessed whether low levels of HDL-C were associated with an increased risk of adverse outcomes among AIS patients with DM.
We described continuous variables as mean±SD or median (interquartile range) and categorical variables as proportions. Baseline characteristics stratified by HDL-C quintiles were compared by χ2 test for categorical variables and Kruskal-Wallis test for continuous variables for difference between the 5 groups. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% CIs. A 2-tailed P of <0.05 was considered as statistical significance. All statistical analyses were carried out by SAS software, version 9.4 (SAS Institute, Inc, Cary, NC).
There were linear associations between HDL-C levels and the risks of both recurrent stroke and MACEs. Low HDL-C levels were associated with higher risks of recurrent stroke and MACEs within 1 year in AIS patients with diabetes mellitus.
Patients in the lowest quintile of HDL-C had a higher risk of recurrent stroke (hazard ratio (HR) 1.59, 95% confidence interval (CI), 1.12–2.25) and MACEs (HR 1.53, 95% CI, 1.09–2.15) during 1-year follow-up compared with those in the highest quintile of HDL-C.