Study Of The Correlation Between Middle Cerebral Artery Stenosis And High-density Lipoprotein Cholesterol And Other Risk Factors

Objective:By comparing the degree of atherosclerotic stenosis of middle cerebral artery in patients with abnormal lipid metabolism,the correlation between high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG)and other related risk factors and atherosclerotic stenosis of middle cerebral artery was analyzed.Methods:In this retrospective analysis,309 patients diagnosed with ischemic stroke who were admitted to the Department of Neurology of Linyi People’s Hospital from November2013 to December 2019 were included.High-resolution magnetic resonance imaging(HRMRI)examinations and basic patient information were collected within one week of admission.According to HRMRI results and WASID diagnostic criteria,the patients were divided into normal group(n = 45)and middle cerebral artery(MCA)atherosclerotic stenosis group(n = 264),mild stenosis group(n = 77)and moderate stenosis group(n =48)(n = 50%-69%).The total number of patients in the severe stenosis group was 139(stenosis degree >Chi-square test was first used to compare the differences in levels of HDL-C,LDL-C,TC,TG and other indicators among the groups.Then,univariate and multivariate analysis was performed by multivariate ordered Logistic regression to explore the independent risk factors for the occurrence of atherosclerotic stenosis in MCA.Results:The results showed that dyslipidemia,gender and history of hypertension were all associated with the risk of MCA atherosclerotic stenosis.There were significant differences in HDL-C levels among the four groups.With the degree of stenosis deepening,the proportion of low HDL-C(≤ 1.03mmol/L)population increased,with statistical difference(χ2=34.142,P < 0.01).Regression analysis showed that reduced HDL-C level was an independent risk factor for the disease(OR=3.677,95% C.I.: 2.235～ 6.049,P=0.000),and the higher the HDL,the lower the risk of stenosis.Elevated LDL-C level was also an independent risk factor for MCA(OR=1.840,95% C.I.:1.189-4.133,P=0.015),and the higher the LDL-C level was,the higher the risk of MCA atherosclerotic stenosis.Gender(OR = 1.846,95% C.I.: 1.046-3.259)and history of hypertension(OR = 2.001,95% C.I.: 1.225-3.191)were also independent risk factors for this disease.Conclusion:Both decreased HDL-C level and increased LDL-C level are associated with atherosclerotic stenosis in MCA.Both are independent risk factors for atherosclerotic stenosis in MCA,and the correlated levels can be used as risk assessment indicators for the degree of atherosclerotic stenosis in MCA.Therefore,active management of abnormal lipid metabolism is of great significance for the prevention and treatment of MCA atherosclerotic stenosis.Hypertension and gender are independent risk factors for the occurrence of middle cerebral artery stenosis,suggesting that the clinical necessity of blood pressure control in male patients with MCA atherosclerotic stenosis is more urgent.