Association Of Apolipoprotein A1、B With Stenosis Of Intracranial And Extracranial Arteries In Patients With Atherosclerotic Cerebral Infarction

Objective:To investigate the distribution of stenosis of intracranial and extracranialarteries in Fujian Han population patients suffered from atherosclerotic cerebralinfarction,and to determine the correlation of apolipoprotein A1and apolipoprotein Bwith intracranial and extracranial atherosclerosis stenosis.Methods：For this study,we enrolled patients with atherosclerotic cerebral infarctionbetween December2009and October2012at the neurology department of The FirstAffiliated Hospital of Fujian Medical University. All patients were examined by CTAor MRA to subdivided into extracranial and intracranial categories. Collected pastmedical history, demographic data,biochemical markers.The multiple logisticregression analyses were used to study the association between apoA1、apoB andcerebral atherosclerosis stenosis.Evaluation of diagnostic value of apoB in cerebralatherosclerosis stenosis by receiver operating characteristic(ROC) analysis.Results:A total of412patients were included.137cases(33.3%)in intracranial stenosis(NCAS) group,74cases(18.0%)in combined intracranial and extracranial stenosis(COMS)group,44cases(0.7%)in extracranial carotid stenosis(ECAS) group,157cases(38.1%)in non-cerebral stenosis (NSAS) group.Compared with NCAS group,apoB issignificantly higher(P<0.001),apoA1is significantly lower in ICAS group and COMSgroup.(P=0.02andP=0.030).Compared with mild stenosis group,apoA1is lower inmoderate to severe intracranial stenosis group(P<0.001),apoB is higher in moderate tosevere extracranial stenosis group(P=0.03). The multiple logistic regression analysesshowed that when apoA1>1.28g/L,it was an independent protective factor ofintracranial stenosis(OR,0.39),apoB was an independent risk factor of cerebralatherosclerosis stenosis,when apoB>1.16,it will be most significant (ICAS:OR,6.41)（ECAS:OR,5.15).ROC analysis show that apoB≥0.91g/L indicated the possible riskof cerebral atherosclerosis stenosis（AUC:0.76；sensitivity:81.2%，specificity:83.1%).Conclusion：1.The occurrence of stenosis in intracranial arteries is more frequent thanthat in extracranial arteries in Fujian Han population with atherosclerotic cerebral infarction;2.ApoB was independently risk factor of intracranial and extracranialarteriesstenosis, apoA1was associated with the degree of intracranial stenosis,andindependently protector of intracranial stenosis;3.apoB≥0.91g/L indicated the possiblerisk of cerebral atherosclerosis stenosis.