The Role Of Estrogen For Lipid Metabolism And Atherosclerotic Ischemia Stroke

Objective:Epidemiology studies showed that the incidence of cerebrovascular disease waslower in premenopausal female than in male. And the incidence of stroke increasedobviously when the level of estrogen decreased in postmenopausal women, whichillustrate the correlation between stroke and estrogen impairment. However, theclinical application studies of estrogen for stroke were insufficiency. It need to befurther investigated the mechanism of estrogen to ischemic stroke, and the role ofestrogen for lipid metabolism, development of atherosclerotic and plaque stability.Method:The subjects were postmenopausal women with acute ischemic stroke including acutecerebral infarction and transient ischemia attack. The levels of estrogen, totalcholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein,apolipoprotein, lipoprotein(a) were measured. The media intima-media thickness,inner diameter, peak flow rate of carotid, the character, stability of plaque, and thedegree of stenosis were observed. The data was compared with health control groupResult:1. Compared with control group, the levels of estrogen were lower in the groups ofACI and TIA. The estrogen levels were lower in the group of ACI than TIA. Thelevels of TC, TG and LDL, there were no significant different between ACI groupand TIA group, were higher in the groups of ACI and TIA than in control group,Compared with TIA group and control group, the levels of ApoB and Lp(a) werehigher in ACI group, there were no significant different between TIA group and control group. The levels of ApoA-I were no significant different among threegroups.2. The rank correlation analysis showed the positive correlation between estrogenand HDL(r_s=0.349, p=0.000); the negative correlation between estrogen andLDL(r_s=-0.505, p=0.000). There is no rank correlation between estrogen and TC,TG, ApoA-I, ApoB, as well as Lp(a).3. With the carotid vascular ultrasound, The inner diameter, peak flow rate of bothCCA, ICA, and VA were no significant different among three groups. There wasno significant different among three groups for the distribution of plaques.4. The total detection rate of incrassate carotid intima-media thickness was 52.48%,there was no significant different among three groups. The total detection rate ofinstability plaque was 28.71%. The detection rate of instability plaque, was38.46% in ACI group; 34.38% in TIA group; and 10.00% in control group, therewas no significant different between ACI group and TIA group. There was nosignificant different among three groups for the detection rate of stability plaque.The detection rate of stenosis were low (2.97%) in three groups (2 in ACI groupand 1 in TIA group). It was no significant.5. Estrogen decreasing is not an independence risk for the instability ofatherosclerotic plaque.Conclusion:The estrogen decreasing in postmenopausal women can cause the level of bloodfat abnormal, especially LDL increasing and HDL decreasing. The abnormal lipidmetabolism is an important risk for the development of atherosclerosis and instabilityplaque. The estrogen has the remote negative effects for the development ofatherosclerosis and instability plaque, which cause the women stroke raised. Thecarotid vascular ultrasound can evaluate the degree of atherosclerosis and the stability of plaque. It has an important role for determine the interfere juncture for thetreatment of cutting down blood fat, stabilizing plaque, decreasing the incidence ofstroke. It also has help for the etiological diagnosis of acute cerebral infarction, whichcan guide the clinical treatment.