| Objective:To investigate the relationship between the different low density lipoprotein(LDL)subclasses the stability of carotid plaque and the occurrence of acute cerebral infarction(ACI).Methods:The patients who were hospitalized and could cooperate with the improvement of carotid ultrasound were selected and divided into different groups according to the plaque stability suggested by the results of carotid ultrasound.The patients with stable plaque were divided into one group(n=60)and the patients with unstable plaque were divided into another group(n=60).The patients were divided into two groups according to whether they met the diagnostic criteria of ACI.The patients with stable plaque had 27 cases of new ACI and 33 cases of without ACI;the patients with unstable plaque had34 cases of new ACI and 26 cases of without ACI.The age,glycosylated hemoglobin(Ghb),homocysteine(Hcy)of the patients were collected.The contents of the different low-density lipoprotein subclasses in the patients were measured by LIPOPRINT system.The total cholesterol(TC),low-density lipoprotein(LDL)cholesterol,triglyceride(TG)of the patients were measured and collected.The plaque stability was assessed by carotid artery color Doppler ultrasound and the carotid plaque thickness was measured.Spearman correlation analysis and binary logistic regression analysis were used to study the relationship between different LDL subclasses and plaque stability and the pathogenesis of ACI.Results:1.The content of LDL-1 subclass 17.50(12.00,24.50)in stable plaque group was higher than that 14.00(11.25,17.75)in unstable plaque group(P<0.05).The content of LDL-3 subclass 13.00(11.00,16.00),LDL-4 subclass7.00(3.00,9.00)and sd-LDL1.50(0.00,3.00)in unstable plaque group was higher than LDL-3 subclass 11.00(8.00,13.00),LDL-4 subclass 3.00(2.00,7.00)and sd-LDL0.00(0.00,1.00)in stable plaque group(P<0.05).2.The LDL-1 subclass(crude 0R=0.925 P<0.01),LDL-3 subclass(crude 0R=1.127 P<0.01),LDL-4 subclass(crude 0R=1.130 P<0.01)and sd-LDL(crude 0R=1.406 P<0.01)all had an effect on plaque stability,but the LDL-4 subclass(adjusted OR 95%CI(0.882～1.127)P>0.05)on plaque stability was not statistically significant;while the LDL-1 subclass(adjusted0R=0.936 P<0.05),LDL-3 subclass(adjusted 0R=1.109 P<0.05),and sd-LDL(adjusted OR=1.303 P<0.05)were independent risk factors for plaque stability.The accuracy of the LDL-1 subclass for diagnosing stable plaques was 62.8%;the accuracy of the LDL-subclass for diagnosing unstable plaques was 68.2%The accuracy of the sd-LDL content for diagnosing unstable plaques was 67.0%.3.Only the difference of LDL-3 subclass content between the two groups of patients with stable plaque ACI and those without ACI was statistically significant(P<0.05),while there were no statistically significant differences in other influencing factors such as other LDL subclasses content and basic data(P>0.05).The content of LDL-3 subclass was higher in patients with new acute cerebral infarction in stable plaques,and there was a positive correlation between LDL-3 subclass and the occurrence of ACI(r_s=0.264 P<0.05).However,LDL-3 subclass(crude OR 95%CI(0.996～1.275)P>0.05)was not a risk factor for the occurrence of ACI.In patients with new ACI within the unstable plaque group only the LDL-1 subclass was less abundant than in patients without ACI(P<0.05).There was a negative correlation between the LDL-1 subclass and the occurrence of ACI(r_s=-0.362 p<0.01).Moreover,there was a statistically significant degree of effect caused by the LDL-1 subclass(adjusted OR=0.896 P<0.05)on the occurrence of ACI.Conclusion:The increase of serum LDL-1 subclass can inhibit the formation of unstable plaques,and the increase of serum LDL-3 subclass,sd-LDL can promote the formation of unstable plaques.In patients with unstable plaques,LDL-1 subclass was negatively correlated with the occurrence of ACI,and subclasses such as LDL-3 were positively correlated with the occurrence of ACI. |
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