Ewha Med J.  2012 Mar;35(1):21-25. 10.12771/emj.2012.35.1.21.

Apolipoprotein B/A1 Ratio as Risk Factor for Cerebral Ischemic Stroke

• Hahm C
• Hong KS

• KMID: 2134941
• DOI: http://doi.org/10.12771/emj.2012.35.1.21

Abstract

OBJECTIVES
According to current knowledge, apolipoprotein B/A1 (apoB/A1) ratio is like to be risk factor in coronary artery disease. There is evidence form case-control studies that apoB/A1 ratio may be a superior to LDL and HDL cholesterol in discriminating coronary artery disease case subject from control subject. However, relationship between apoB/A1 ratio and cerebral ischemic stroke is undefined. The main object of this study is to determine whether the risk of cerebral ischemic stroke is related to levels of apoB/A1.
METHODS
The study group included 643 patients (Men, 372; Women, 271) who diagnosed cerebral ischemic stroke between January 2008 to December 2010. The control groups were composed of 378 patients (Men, 139; Women, 239) who diagnosed other neurological disease. The correlation between lipid profiles and odds ratio of 10 preliminary risk factors (total cholesterol, triglyceride, LDL, HDL, apoA1, apoB, apoB/A1 ratio, non HDL, total cholesterol/HDL ratio, LDL/HDL ratio) for stroke were analyzed.
RESULTS
ApoB/A1 ratio was significantly increased in case patients compared with control subjects. Multivariate logistic regression analysis identified decrease of apoB/A1 ratio (odds ratio [OR], 1.583; 95% confidence intercal [CI], 1.105~2.269) as significantly associated with stroke. Individual apoA1 (OR, 1.303; 95% CI, 0.967~1.755) and apoB (OR, 1.397; 95% CI, 0.773~2.523) were also not significantly associated with cerebral ischemic stroke.
CONCLUSION
Increase of apoB/A1 ratio is associated with an increase risk of cerebral ischemic stroke. Use of apoB/A1 ratio is efficient as conventional lipids, for the identification of subjects at increased risk of stroke. So apoB/A1 ratio to standard lipid profile testing could improve the evaluation of risk factors of cerebral ischemic stroke.

Keyword

Apolipoprotein B/A1 ratio; Cerebral ischemic stroke; Odds ratio

MeSH Terms

Apolipoproteins
Apolipoproteins B
Case-Control Studies
Cholesterol
Cholesterol, HDL
Coronary Artery Disease
Female
Humans
Logistic Models
Odds Ratio
Risk Factors
Stroke
Apolipoproteins
Apolipoproteins B
Cholesterol
Cholesterol, HDL

Reference

1. Saenger AK, Christenson RH. Stroke biomarkers: progress and challenges for diagnosis, prognosis, differentiation, and treatment. Clin Chem. 2010. 56:21–33.

2. Health Insurance Review and Assessment Service. Report on adequacy for stroke. 2007. Seoul: Health Insurance Review and Assessment Service.

3. Milionis HJ, Liberopoulos E, Goudevenos J, Bairaktari ET, Seferiadis K, Elisaf MS. Risk factors for first-ever acute ischemic non-embolic stroke in elderly individuals. Int J Cardiol. 2005. 99:269–275.

4. Jia Q, Liu L, Wang Y. Risk factors and prevention of stroke in the Chinese population. J Stroke Cerebrovasc Dis. 2011. 20:395–400.

5. Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy. A review of the evidence. J Intern Med. 2006. 259:493–519.

6. Meisinger C, Loewel H, Mraz W, Koenig W. Prognostic value of apolipoprotein B and A-I in the prediction of myocardial infarction in middle-aged men and women: results from the MONICA/KORA Augsburg cohort study. Eur Heart J. 2005. 26:271–278.

7. Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non-HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005. 294:326–333.

8. Shahar E, Chambless LE, Rosamond WD, Boland LL, Ballantyne CM, McGovern PG, et al. Plasma lipid profile and incident ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) study. Stroke. 2003. 34:623–631.

9. Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G. Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2009. 265:275–287.

10. Walldius G, Aastveit AH, Jungner I. Stroke mortality and the apoB/apoA-I ratio: results of the AMORIS prospective study. J Intern Med. 2006. 259:259–266.