The Correlation Between The Subcomposition Of Lipid And Carotid Intima Thickness And Plaque In Patients With Large Atherosclerotic Cerebral Infarction

Objective: The subcomposition of lipid was analyzed from patients with large atherosclerotic cerebral infarction.The main purposes of this study were to explore the relationship of the subcomposition of lipid and carotid intima thickness,as well as carotid plaque,in order to providing a reference for the clinical treatment of large atherosclerotic cerebral infarction patients.Methods: Forty-six patients with atherosclerotic cerebral infarction and 23 normal controls during the same period were recruited in The People’ s Hospital of Jianyang city between July 2021 and October 2022.The ischemic stroke was diagnosed by according to the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke proposed by China in 2018,and atherosclerotic cerebral infarction in TOAST classification.Samples of plasma were analyzed by vertical auto profile lipid panel plus(VAP +)for blood lipids in all included subjects.The carotid intimal thickness and plaque vulnerability were detected by cervical vascular ultrasound.Results:(1)A total of 69 subjects were enrolled in this study,including 46 in the cerebral infarction group and 23 in the healthy control group.There were no differences in gender,age,smoking,alcoholism,intermediate-density lipoprotein(IDL),very low-density lipoprotein(VLDL)and remnant lipoprotein particles(RLP)between the two groups(P > 0.05).The incidence of diabetes mellitus and hypertension in cerebral infarction group was significantly higher than that in healthy control group(P < 0.05).TC(4.74±1.20mmol/L),LP(a)(200.33±88.57mg/L),TG(1.87±0.75mmol/L)and LDL(3.01±0.94mmol/L)levels in cerebral infarction group were significantly higher than that in healthy control group(P < 0.05).However,the high density lipoprotein(HDL)(1.43±0.50mmol/L)level of cerebral infarction group was significantly lower than that of healthy control group(P < 0.05).(2)The multi-factor logistic regression analysis showed that diabetes mellitus,hypertension,TC,LP(a),TG as well as LDL were risk factors for cerebral infarction patient.HDL was a protective factor in patients with cerebral infarction.(3)The cerebral infarction group was divided into two groups,18 cases of normal intima and 28 cases of thickened intima.There were no differences in gender,age,smoking,alcoholism,IDL,VLDL as well as RLP(P > 0.05).The incidence of diabetes and hypertension in endometrial thickening group was significantly higher than that in normal endometrial group(P < 0.05).TC(5.33±1.01mmol/L),LP(a)(228.44±95.40mg/L),TG(2.08±0.76mmol/L),as well as LDL(3.24±0.95mmol/L)levels of endometrial thickening group were significantly higher than that of normal endometrial group(P < 0.05).The HDL(1.30±0.49mmol/L)level in the intima thickening group was significantly lower than that in the normal intima group(P < 0.05).(4)The multi-factor logistic regression analysis showed that diabetes mellitus,hypertension,TC,LP(a),TG as well as LDL were risk factors for endometrial thickening group.HDL was a protective factor in patients with cerebral endometrial thicken.(5)The thickened intima subjects were divided into16-vulnerable-plaque group and 12-non-vulnerable plaque group.The results showed that there were no differences in gender,age,smoking,alcoholism,IDL,VLDL as well as RLP(P > 0.05).Compared with non-vulnerable plaque group,TC(5.82±0.93 mmol/L),LP(a)(261.37±95.52mg/L),TG(2.43±0.66mmol/L),as well as LDL(3.64±0.87mmol/L)levels of vulnerable plaque group were significantly higher(P < 0.05).The HDL(1.13±0.35mmol/L)level in the vulnerable plaque group was significantly lower(P < 0.05).(6)The multi-factor logistic regression analysis showed that hypertension,TC,LP(a),TG as well as LDL were risk factors for vulnerable plaque group.HDL was a protective factor in patients with vulnerable plaque group.Conclusion:1.Through the study on lipid components,we found that the levels of TC,TG,LDL,HDL and Lp(a)were all related to the occurrence of carotid atherosclerosis.2.The levels of TC,TG,LDL and Lp(a)were positively correlated with carotid intima thickness and vulnerable plaque.3.HDL level was negatively correlated with carotid intima thickness and plaque.