Serum Homocysteine Is Associated With HDL Only in Stroke Patients With Small Vessel Occlusion
Open Access
- 2 December 2020
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Neurology
Abstract
Background: Although controversial, homocysteine (Hcy) and lipid parameters have been associated with particular stroke subtypes. However, there are limited studies concerning the relationship between Hcy and lipid levels in acute ischemic stroke (AIS). We evaluated the impact of Hcy levels on lipid profiles in terms of specific stroke subtypes. Methods: A total of 2,324 patients with first-ever AIS were recruited from two hospitals in South Korea. The exclusion criteria were as follows: (a) pre-stroke modified Rankin scale (mRS) ≥ 1, (b) undetermined or other stroke etiology, and (c) absence of Hcy data. Among the 1,580 eligible patients, the Hcy level was divided into tertile groups. Logistic regression was used to assess association of Hcy levels with lipid levels by stroke subtypes. Results: Significant downward trends in total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were only observed in patients with small vessel occlusion (SVO) as Hcy increased. In logistic regression analysis, while in patients with SVO subtype, the highest level of Hcy tertiles (OR = 1.648, 95% CI = 1.047–2.594) was associated with the lower HDL level (≤40 mg/dL), the significance disappeared in patients with LAA and CE subtypes. Conclusion: Although our study does not demonstrate causal relationship, we suggest that Hcy might play a mediating role between HDL and SVO stroke development. To clarify the role of Hcy on AIS, this study will provide academic support for designing future research.Funding Information
- National Research Foundation of Korea (NRF-2018R1C1B5086320)
This publication has 24 references indexed in Scilit:
- Lipid profile and levels of homocysteine and total antioxidant capacity in plasma of rats with experimental thyroid disordersThe Journal of Basic & Applied Zoology, 2015
- Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Classification and Vascular Territory of Ischemic Stroke Lesions Diagnosed by Diffusion‐Weighted ImagingJournal of the American Heart Association, 2014
- Homocysteine and ischemic stroke subtype: a relationship study in Chinese patientsNeurological Research, 2010
- Homocysteine and Its Relationship to Stroke Subtypes in a UK Black PopulationStroke, 2008
- Lipid levels and the risk of ischemic stroke in womenNeurology, 2007
- Relationship of plasma homocysteine with lipid profile parameters in ischemic heart diseaseIndian Journal of Clinical Biochemistry, 2006
- Plasma Lipid Profile and Incident Ischemic StrokeStroke, 2003
- Plasma Total Homocysteine and Hospitalizations for Cardiovascular DiseaseArchives of Internal Medicine, 2002
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke, 1993
- A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physiciansJAMA, 1992