Associations Of Blood Lipid Levels And Their Changes With Incident Stroke In Middle-aged And Elderly People

Objective: The purpose of our study is to investigate the association of blood lipidlevels and their changes with incident stroke,including hemorrhagic stroke and ischemic stroke.Besides,the study can provide evidences for the prevention,treatment and management of stroke.Methods: Our study was based on the baseline data of the Dongfeng-Tongji cohort and the information of the first follow-up survey.After excluding those with coronary heart disease(CHD),stroke,cancer at baseline,lost of follow-up or the missing or extreme data of blood lipid,27149 participants were included in the association analysis of baseline lipid level and lipid lipid ratio with stroke.In the analyses of the association between blood lipid changes and stroke,the changes of total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol were included in 12699,12770,12646 and 12654 participants,respectively.Cox proportional risk model was used to evaluate the correlation of blood lipids and their changes and ratios with incident stroke.The hazard ratio(HR)and its 95% confidence interval(CI)were used to express the correlation.Results: During the follow-up period,1053 strokes were identified(839 ischemic and 214 hemorrhagic).Compared with the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol in the lowest quartile,the adjusted HR of the ratio in the highest quartile was 0.60(95% CI: 0.40-0.92).Compared with the stable group,the adjusted HR of ischemic stroke was 1.49(95% CI: 1.01-2.21)in the total cholesterol elevation group,while adjusted HRs of total stroke and ischemic stroke were0.60(95% CI: 0.42-0.85)and 0.62(95% CI: 0.42-0.91)in the triglyceride reduction group,1.34(95% CI: 1.00-1.80)and 1.39(95% CI: 1.01-1.93)in the high density lipoprotein cholesterol reduction group.Conclusions: This study found that lower ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol was associated with lower risk of hemorrhagic stroke.In addition,increased total cholesterol and decreased high density lipoprotein cholesterol were associated with higher risk of ischemic stroke,while decreased triglyceride was associated with lower risk of ischemic stroke.