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Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack

Yıl 2020, Cilt: 22 Sayı: 3, 191 - 195, 30.12.2020
https://doi.org/10.18678/dtfd.737978

Öz

Aim: Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is defined as the serum atherogenicity index. High TG/HDL-C ratio is related with vascular diseases, insulin resistance and metabolic syndrome. The TG/HDL-C ratio in cerebrovascular diseases, especially in silent cerebral lesions hasn’t been well studied. The aim of this study was to evaluate the frequency of silent cerebral ischemia (SCI) and leukoaraiosis (LA), and its relationship with TG/HDL-C ratio in patients admitted with the first ischemic stroke attack.
Material and Methods: We retrospectively evaluated 200 patients who admitted to Bulent Ecevit University Faculty of Medicine, Department of Neurology with the diagnosis of acute first ischemic stroke. Silent cerebral lesions were defined as LA and SCI with magnetic resonance imaging. TG/HDL-C ratio was calculated by dividing TG levels by HDL-C levels.
Results: Silent cerebral lesions were detected 124 (83.2%) of 149 patients. LA severity was evaluated according to Fazekas score, 22 (14.8%) of patients were grade 0, 49 (32.9%) of them were grade 1, and 78 (52.3%) of them were advanced periventricular white matter hyperintensity (adv-PWMH) group. TG/HDL-C ratio in SCI group was higher than the group without SCI, but it wasn’t statistically significant (p=0.091). A significant increase was observed in the TG/HDL-C ratio, as LA severity increased. TG/HDL-C ratio was significantly higher in adv-PWMH group (p=0.050).
Conclusion: High serum atherogenicity index is associated with atherosclerosis and vascular endothelial dysfunction. With this simple, inexpensive and effective test method, high-risk group of LA and SCI could be identified.

Kaynakça

  • Donkor ES. Stroke in the 21st century: A snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat. 2018;2018:3238165.
  • Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Neurology in Clinical Practice. Çeviri: Tan E, Erdem Özdamar S. Ankara: Veri Medikal Yayıncılık; 2008. p.1165-1170.
  • Vermeer SE, Longstreth WT Jr, Koudstaal PJ. Silent brain infarcts: systematic review. Lancet Neurol. 2007;6(7):611-9.
  • Oh SH, Kim NK, Kim SH, Kim JK, Kim HS, Kim WC, et al. The prevalence and risk factor analysis of silent brain infarction in patients with first-ever ischemic stroke. J Neurol Sci. 2010;293(1-2):97-101.
  • Ay H, Arsava EM, Rosand J, Furie KL, Singhal AB, Schaefer PW, et al. Severity of leukoaraiosis and susceptibility to infarct growth in acute stroke. Stroke 2008;39(5):1409-13.
  • Ovbiagele B, Saver JL. Cerebral white matter hyperintensities on MRI: current concepts and therapeutic implications. Cerebrovasc Dis. 2006;22(2-3):83-90.
  • Acıman Demirel E, Emre U, Ünal A, Özen B, Atasoy HT, Öztürk F. Evaluation of silent cerebral lesions in patients with first ischemic stroke attack. Neurol Psychiat Br. 2012;18(1); 22-6.
  • Inoue K, Matsumoto M, Shono T, Toyokawa S, Moriki A. Increased intima media thickness and atherosclerotic plaques in the carotid artery as risk factors for silent brain infarcts. J Stroke Cerebrovasc Dis. 2007;16(1):14-20.
  • Nam KW, Kwon HM, Jeong HY, Park JH, Kwon H, Jeong SM. High triglyceride/HDL cholesterol ratio is associated with silent brain infarcts in a healthy population. BMC Neurol. 2019;19(1):147.
  • Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-110.
  • da Luz PL, Favarato D, Faria-Neto JR Jr, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics (Sao Paulo). 2008;63(4):427-32.
  • Söğüt E, Avcı E, Üstüner F, Arıkan E. The evaluation of (TG/HDL-C) ratio as a serum atherogenic index. Türk Klinik Biyokimya Derg. 2006;4(1):1-8.
  • Pacifico L, Bonci E, Andreoli G, Romaggioli S, Di Miscio R, Lombardo CV, et al. Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents. Nutr Metab Cardiovasc Dis. 2014;24(7):737-43.
  • Hermans MP, Ahn SA, Rousseau MF. The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females. Lipids Health Dis. 2012;11:132.
  • Deng QW, Wang H, Sun CZ, Xing FL, Zhang HQ, Zuo L, et al. Triglyceride to high-density lipoprotein cholesterol ratio predicts worse outcomes after acute ischaemic stroke. Eur J Neurol. 2017;24(2):283-91.
  • Kılıç Çoban E. Can TG/HDL ratio be an accurate predictor in the determination of the risk of cerebrovascular events in youngsters? Sisli Etfal Hastan Tip Bul. 2018;52(3):201-5.
  • Scheltens P, Erkinjunti T, Leys D, Wahlund LO, Inzitari D, del Ser T, et al. White matter changes on CT and MRI: an overview of visual rating scales. European Task Force on Age-Related White Matter Changes. Eur Neurol. 1998;39(2):80-9.
  • Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJNR Am J Neuroradiol. 1987;8(3):421-6.
  • Ke D, Zhou F, Liang H, Xu Y, Lou H. Hypertriglyceridemia is associated with reduced leukoaraiosis severity in patients with a small vessel stroke. Behav Neurol. 2018;2018:1361780.
  • Vedala K, Nagabandi AK, Looney S, Bruno A. Factors associated with leukoaraiosis severity in acute stroke patients. J Stroke Cerebrovasc Dis. 2019;28(7):1897-901.
  • Jimenez-Conde J, Biffi A, Rahman R, Kanakis A, Butler C, Sonni S, et al. Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke. Stroke. 2010;41(3):437-42.
  • Lin J, Wang D, Lan L, Fan Y. Multiple factors involved in the pathogenesis of white matter lesions. BioMed Res Int. 2017;2017:9372050.
  • Park K, Yasuda N, Toyonaga S, Yamada SM, Nakabayashi H, Nakasato M, et al. Significant association between leukoaraiosis and metabolic syndrome in healthy subjects. Neurology. 2007;69(10):974-8.
  • Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation 1997;96(8):2520-5.
  • Park JH, Lee J, Ovbiagele B. Nontraditional serum lipid variables and recurrent stroke risk. Stroke. 2014;45(11):3269-74.
  • Guan J, Yan C, Gao Q, Li J, Wang L, Hong M, et al. Analysis of risk factors in patients with leukoaraiosis. Medicine. 2017;96(8):e6153.
  • Hoth KF, Tate DF, Poppas A, Forman DE, Gunstad J, Moser DJ, et al. Endothelial function and white matter hyperintensities in older adults with cardiovascular disease. Stroke. 2007;38(2):308-12.
  • Nam KW, Kwon HM, Jeong HY, Park JH, Kim SH, Jeong SM, et al. Cerebral white matter hyperintensity is associated with intracranial atherosclerosis in a healthy population. Atherosclerosis 2017;265:179-83.

İlk İnme Atağı Olan Olgularda Sessiz Serebral Lezyonların Trigliserid/HDL-Kolesterol Oranı ile İlişkisinin Değerlendirilmesi

Yıl 2020, Cilt: 22 Sayı: 3, 191 - 195, 30.12.2020
https://doi.org/10.18678/dtfd.737978

Öz

Amaç: Trigliserid/yüksek yoğunluklu lipoprotein kolesterol (TG/HDL-K) oranı serum aterojenite indeksi olarak tanımlanmıştır. Yüksek TG/HDL-K oranı vasküler hastalıklar, insülin direnci ve metabolik sendrom ile ilişkilidir. Serebrovasküler olaylarda özellikle sessiz serebral lezyonlarda TG/HDL-K oranı ile ilgili çalışmalar azdır. Bu çalışmanın amacı, ilk iskemik inme atağı ile başvuran hastalarda sessiz serebral iskemi (SSİ) ve lökoariozis (LA) sıklığını ve TG/HDL-K oranı ile ilişkisini değerlendirmektir.
Gereç ve Yöntemler: Bülent Ecevit Üniversitesi Tıp Fakültesi Nöroloji bölümüne akut ilk iskemik inme tanısı ile başvuran 200 hasta geriye dönük olarak değerlendirildi. Manyetik rezonans görüntüleme ile sessiz serebral lezyonlar SSİ ve LA olarak tanımlandı. TG/HDL-K oranı TG değerinin HDL-K değerine bölünmesi ile hesaplandı.
Bulgular: Yüz kırk dokuz hastanın 124 (%83,2)’ünde sessiz serebral lezyon saptandı. LA şiddeti Fazekas skorlamasına göre değerlendirildi, hastaların 22 (%14,8)’si grade 0, 49 (%32,9)’u grade 1 ve 78 (%52,3)’i ileri düzey periventriküler beyaz cevher lezyonu (advanced periventricular white matter hyperintensity, adv-PWMH) grubundaydı. SSİ grubunda TG/HDL-K oranı SSİ olmayan gruba göre daha yüksek bulundu, ancak istatistiksel olarak anlamlı değildi (p=0,091). LA şiddeti arttıkça TG/HDL-K oranında anlamlı bir artış olduğu izlendi. TG/HDL-K oranı, adv-PWMH grubunda anlamlı derecede yüksek idi (p=0,050).
Sonuç: Yüksek serum aterojenite indeksi ateroskleroz ve vasküler endotelyal disfonksiyon ile ilişkilidir. Bu basit, ucuz ve etkili test yöntemi ile LA ve SSİ yüksek risk grubu belirlenebilir.

Kaynakça

  • Donkor ES. Stroke in the 21st century: A snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat. 2018;2018:3238165.
  • Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Neurology in Clinical Practice. Çeviri: Tan E, Erdem Özdamar S. Ankara: Veri Medikal Yayıncılık; 2008. p.1165-1170.
  • Vermeer SE, Longstreth WT Jr, Koudstaal PJ. Silent brain infarcts: systematic review. Lancet Neurol. 2007;6(7):611-9.
  • Oh SH, Kim NK, Kim SH, Kim JK, Kim HS, Kim WC, et al. The prevalence and risk factor analysis of silent brain infarction in patients with first-ever ischemic stroke. J Neurol Sci. 2010;293(1-2):97-101.
  • Ay H, Arsava EM, Rosand J, Furie KL, Singhal AB, Schaefer PW, et al. Severity of leukoaraiosis and susceptibility to infarct growth in acute stroke. Stroke 2008;39(5):1409-13.
  • Ovbiagele B, Saver JL. Cerebral white matter hyperintensities on MRI: current concepts and therapeutic implications. Cerebrovasc Dis. 2006;22(2-3):83-90.
  • Acıman Demirel E, Emre U, Ünal A, Özen B, Atasoy HT, Öztürk F. Evaluation of silent cerebral lesions in patients with first ischemic stroke attack. Neurol Psychiat Br. 2012;18(1); 22-6.
  • Inoue K, Matsumoto M, Shono T, Toyokawa S, Moriki A. Increased intima media thickness and atherosclerotic plaques in the carotid artery as risk factors for silent brain infarcts. J Stroke Cerebrovasc Dis. 2007;16(1):14-20.
  • Nam KW, Kwon HM, Jeong HY, Park JH, Kwon H, Jeong SM. High triglyceride/HDL cholesterol ratio is associated with silent brain infarcts in a healthy population. BMC Neurol. 2019;19(1):147.
  • Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018;49(3):e46-110.
  • da Luz PL, Favarato D, Faria-Neto JR Jr, Lemos P, Chagas AC. High ratio of triglycerides to HDL-cholesterol predicts extensive coronary disease. Clinics (Sao Paulo). 2008;63(4):427-32.
  • Söğüt E, Avcı E, Üstüner F, Arıkan E. The evaluation of (TG/HDL-C) ratio as a serum atherogenic index. Türk Klinik Biyokimya Derg. 2006;4(1):1-8.
  • Pacifico L, Bonci E, Andreoli G, Romaggioli S, Di Miscio R, Lombardo CV, et al. Association of serum triglyceride-to-HDL cholesterol ratio with carotid artery intima-media thickness, insulin resistance and nonalcoholic fatty liver disease in children and adolescents. Nutr Metab Cardiovasc Dis. 2014;24(7):737-43.
  • Hermans MP, Ahn SA, Rousseau MF. The atherogenic dyslipidemia ratio [log(TG)/HDL-C] is associated with residual vascular risk, beta-cell function loss and microangiopathy in type 2 diabetes females. Lipids Health Dis. 2012;11:132.
  • Deng QW, Wang H, Sun CZ, Xing FL, Zhang HQ, Zuo L, et al. Triglyceride to high-density lipoprotein cholesterol ratio predicts worse outcomes after acute ischaemic stroke. Eur J Neurol. 2017;24(2):283-91.
  • Kılıç Çoban E. Can TG/HDL ratio be an accurate predictor in the determination of the risk of cerebrovascular events in youngsters? Sisli Etfal Hastan Tip Bul. 2018;52(3):201-5.
  • Scheltens P, Erkinjunti T, Leys D, Wahlund LO, Inzitari D, del Ser T, et al. White matter changes on CT and MRI: an overview of visual rating scales. European Task Force on Age-Related White Matter Changes. Eur Neurol. 1998;39(2):80-9.
  • Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJNR Am J Neuroradiol. 1987;8(3):421-6.
  • Ke D, Zhou F, Liang H, Xu Y, Lou H. Hypertriglyceridemia is associated with reduced leukoaraiosis severity in patients with a small vessel stroke. Behav Neurol. 2018;2018:1361780.
  • Vedala K, Nagabandi AK, Looney S, Bruno A. Factors associated with leukoaraiosis severity in acute stroke patients. J Stroke Cerebrovasc Dis. 2019;28(7):1897-901.
  • Jimenez-Conde J, Biffi A, Rahman R, Kanakis A, Butler C, Sonni S, et al. Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke. Stroke. 2010;41(3):437-42.
  • Lin J, Wang D, Lan L, Fan Y. Multiple factors involved in the pathogenesis of white matter lesions. BioMed Res Int. 2017;2017:9372050.
  • Park K, Yasuda N, Toyonaga S, Yamada SM, Nakabayashi H, Nakasato M, et al. Significant association between leukoaraiosis and metabolic syndrome in healthy subjects. Neurology. 2007;69(10):974-8.
  • Gaziano JM, Hennekens CH, O'Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein, and risk of myocardial infarction. Circulation 1997;96(8):2520-5.
  • Park JH, Lee J, Ovbiagele B. Nontraditional serum lipid variables and recurrent stroke risk. Stroke. 2014;45(11):3269-74.
  • Guan J, Yan C, Gao Q, Li J, Wang L, Hong M, et al. Analysis of risk factors in patients with leukoaraiosis. Medicine. 2017;96(8):e6153.
  • Hoth KF, Tate DF, Poppas A, Forman DE, Gunstad J, Moser DJ, et al. Endothelial function and white matter hyperintensities in older adults with cardiovascular disease. Stroke. 2007;38(2):308-12.
  • Nam KW, Kwon HM, Jeong HY, Park JH, Kim SH, Jeong SM, et al. Cerebral white matter hyperintensity is associated with intracranial atherosclerosis in a healthy population. Atherosclerosis 2017;265:179-83.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Esra Aciman Demirel 0000-0002-1444-5022

Gülcan Kalaycı Bu kişi benim 0000-0003-2046-6759

Mustafa Açıkgöz Bu kişi benim 0000-0002-0645-5765

Ulufer Çelebi 0000-0001-5785-3379

Bilge Cinar 0000-0002-4884-0717

Hüsyin Tuğrul Atasoy 0000-0003-1631-7400

Yayımlanma Tarihi 30 Aralık 2020
Gönderilme Tarihi 15 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 22 Sayı: 3

Kaynak Göster

APA Aciman Demirel, E., Kalaycı, G., Açıkgöz, M., Çelebi, U., vd. (2020). Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack. Duzce Medical Journal, 22(3), 191-195. https://doi.org/10.18678/dtfd.737978
AMA Aciman Demirel E, Kalaycı G, Açıkgöz M, Çelebi U, Cinar B, Atasoy HT. Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack. Duzce Med J. Aralık 2020;22(3):191-195. doi:10.18678/dtfd.737978
Chicago Aciman Demirel, Esra, Gülcan Kalaycı, Mustafa Açıkgöz, Ulufer Çelebi, Bilge Cinar, ve Hüsyin Tuğrul Atasoy. “Evaluation of the Relationship Between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients With First Stroke Attack”. Duzce Medical Journal 22, sy. 3 (Aralık 2020): 191-95. https://doi.org/10.18678/dtfd.737978.
EndNote Aciman Demirel E, Kalaycı G, Açıkgöz M, Çelebi U, Cinar B, Atasoy HT (01 Aralık 2020) Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack. Duzce Medical Journal 22 3 191–195.
IEEE E. Aciman Demirel, G. Kalaycı, M. Açıkgöz, U. Çelebi, B. Cinar, ve H. T. Atasoy, “Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack”, Duzce Med J, c. 22, sy. 3, ss. 191–195, 2020, doi: 10.18678/dtfd.737978.
ISNAD Aciman Demirel, Esra vd. “Evaluation of the Relationship Between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients With First Stroke Attack”. Duzce Medical Journal 22/3 (Aralık 2020), 191-195. https://doi.org/10.18678/dtfd.737978.
JAMA Aciman Demirel E, Kalaycı G, Açıkgöz M, Çelebi U, Cinar B, Atasoy HT. Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack. Duzce Med J. 2020;22:191–195.
MLA Aciman Demirel, Esra vd. “Evaluation of the Relationship Between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients With First Stroke Attack”. Duzce Medical Journal, c. 22, sy. 3, 2020, ss. 191-5, doi:10.18678/dtfd.737978.
Vancouver Aciman Demirel E, Kalaycı G, Açıkgöz M, Çelebi U, Cinar B, Atasoy HT. Evaluation of the Relationship between Silent Cerebral Lesions and Triglyceride/HDL-Cholesterol in Patients with First Stroke Attack. Duzce Med J. 2020;22(3):191-5.
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