Correlation Study Of Single Lipids And Their Ratio To HDL,ApoB/ApoA-1 Levels And Cerebral Microhemorrhage

Background:Cerebral microbleeds(CMBs)are one of the main neuroimaging markers of cerebral small-vessel disease(CSVD),and with the widespread use of magnetic resonance imaging(MRI)in the diagnosis of neurological disorders,more and more patients with CMBs are being detected.CMBs can lead to abnormalities in specific cognitive domains such as verbal memory,visuospatial function,and language executive function,but their pathogenesis is still not fully understood.Previous studies suggest that serum lipid fractions may play an important role in the pathogenesis of CMBs,but the effect of each lipid fraction on CMBs is inconsistent,so exploring biological markers at the serum lipid level that predict CMBs is of great clinical value.Objective:To analyse the risk factors of lipid fraction affecting cerebral microhemorrhage,and the value of single lipid and its ratio with HDL,ApoB/ ApoA-1 index in predicting the clinical diagnosis of cerebral microhemorrhage and providing reference for early prevention and treatment of cerebral microhemorrhage.Methods:A total of 168 patients who were hospitalized in the Department of Neurology,Huaihe Hospital of Henan University from October 2019 to December 2022 and underwent 3.0T head MRI(including T1,T2,FLAIR,DWI and SWI)were selected.The eligible patients were divided into cerebral microbleeds group(CMBs)and non-CMBs group(N-CMBs).The basic information,past history and laboratory test indicators were collected.Laboratory indicators were fasting sampling on the second day after admission,and blood lipid indicators including total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),apolipoprotein A-1(ApoA-1),apolipoprotein B(ApoB)were recorded,and the blood lipid ratio index was calculated: TC/HDL,TG/HDL,LDL/HDL,Non-HDL/HDL,ApoA-1/HDL,ApoB/ ApoA-1.For categorical variables,the chi-square test was used,and the percentage of values taken was expressed by N(Percent);for continuous variables,the data satisfied normal distribution and were analyzed by independent sample t-test,and the distribution of data was expressed by Mean ±SD.Multi-element logistic regression was applied to analyze the independent risk factors for cerebral microhemorrhage,and the ROC curve analysis was used to assess the lipid and lipid ratio indexes on The predictive value of CMBs was derived from its sensitivity and specificity,and P<0.05 indicated that the difference was statistically significant.Results:A total of 168 patients were included in this study,84 in the cerebral microhemorrhage group,including 55 males and 29 females;84 in the no cerebral microhemorrhage group,including 50 males and34 females;the age was higher and the difference was statistically significant in the cerebral microhemorrhage group compared with the no cerebral microhemorrhage group,and the gender,hypertension,diabetes mellitus,cerebral infarction,coronary artery disease,history of antiplatelet drugs and history of statin drugs were not statistically significant between the two groups.There was no statistically significant difference between the two groups.Among the individual lipid index values,ApoA-1 and ApoB levels were not statistically significant between the two groups(P>0.05),and compared to the cerebral microhemorrhage group,TC(t=3.293,P=0.001),TG(t=2.530,P=0.013),LDL(t=3.979,P<0.001),Non＿HDL(t= 3.306,P=0.001)levels were significantly higher and the difference was statistically significant(P <0.05),and HDL(t=-2.346,P =0.020)levels were significantly lower in the no cerebral microhemorrhage group(p<0.05).Among the lipid ratio indexes,the levels of TC/HDL(t=4.338,P<0.001),TG/HDL(t=2.907,P=0.004),LDL/HDL(t=4.644,P<0.001),and Non HDL/HDL(t=3.787,P<0.001)were higher than those in the cerebral microhemorrhage group,and the ApoB/ApoA-1 index levels were significantly lower than those in the cerebral microhemorrhage group(t=-6.981,P< 0.001),all of which were statistically significant;the difference between the two ApoA-1/HDL groups was not statistically significant(P>0.05).The results of multivariate logistic regression analysis of statistically significant single indicators of lipids and blood lipids after screening showed that TC(OR=0.54,95% CI=0.320-0.911,P=0.021)and LDL(OR=0.436,95% CI=0.231-0.20,P=0.01)were independent protective factors for cerebral microhemorrhage.(all P<0.05);ApoB/ApoA-1(OR=71.88,95% CI=14.255-362.459,P=0.01),HDL(OR=20.537,95% CI=3.276-128.73,P =0.001)were independent risk factors for cerebral microhemorrhage,(all p<0.05).ROC curves were established and the area under the curve was calculated to assess the clinical diagnostic value and accuracy of TC,LDL,HDL,and ApoB/ApoA-1 for cerebral microhemorrhagic disease;the results of ROC curve analysis: the area under the curve of ApoB/ApoA-1 predicted patients in the CMBs group was 0.762,with a critical value of 1.138,sensitivity 52.4%,and specificity 95.2%;The area under the curve for TC predicted patients in the CMBs group was 0.659,with a critical value of 4.865,sensitivity 82.1% and specificity 45.2%;the area under the curve for LDL predicted patients in the CMBs group was 0.682,with a critical value of 2.175,sensitivity 56% and specificity 77.4%;the area under the curve for HDL predicted patients in the CMBs group was 0.599,with a critical value 1.235,with a sensitivity of 34.5% and specificity of 86.9%;summarizing the results of the analysis,it is clear that ApoB/ApoA-1 index has the greatest role in predicting the predictive value of CMBs.Conclusion:1.TC,LDL are independent protective factors for CMBs;ApoB/ApoA-1,HDL are independent risk factors for CMBs.2.ApoB/ApoA-1 index had the greatest role in predicting the predictive value of CMBs.