Relations of dyslipidemia with carotid intima-media thickness and plague in a high-stroke-risk population

Abstract

Background: Dyslipidemia causes the accumulation of lipids in the arterial walls, which complicates the process of atherosclerosis and eventually leads to cerebral infarction. There are few detailed studies on the relationship between stroke, carotid plaque, and dyslipidemia. Aim: This study aimed to determine the relations between dyslipidemia with carotid intima-media thickness (cIMT) and plaques in a Mongolian high-stroke-risk population. Materials and Methods: A hospital-based cross-sectional study was conducted on Mongolian adults (over 55 years) who underwent questionnaire interviews, physical examinations, and laboratory testing from May to July 2022 in the Mongolia-Japan and Enerel hospitals. The subjects with a high risk of stroke were further selected according to Framingham Stroke Risk Score (FSRS). Carotid ultrasonography was then performed on the high stroke risk participants. Carotid plaque was defined as a focal carotid intima-media thickness (cIMT) ≥15 mm or a discrete structure protruding into the arterial lumen at least 50% of the surrounding cIMT. Subjects were divided into two groups according to the presence or absence of carotid plaques. Logistic regression was employed to evaluate the relationship between the lipid parameters and carotid plaques. Results: Overall, 38 subjects with a high risk of stroke out of 130 participants were ultimately included in the analysis, and carotid plaques were identified in 25 (65.4%) of them. Median cIMT was 1.30 mm (1.00, 3.10) in participants and significantly thicker in groups without plague (1.50 mm vs 1.00 mm, p=0,011). Spearman’s correlation demonstrated cIMT was positively correlated with the levels of LDL-C, TC and non-HDL-C (r=0.481, 0.396 and 0.436, p < 0.05) and the ratios of TC/HDL-C (r=0.343, p < 0.05). Among the lipid parameters, the levels of TC, non-HDL-C, and LDL-C were more closely related to cIMT and plaque compared with other lipid parameters in the univariate analyses. In multivariate analyses, gender (β - 0.021, p=0.045 ) remained significantly with cIMT, whereas the non-HDL-C level was a predictive factor for carotid plaque (OR=4.521, 95% CI 1.200–10.230, p=0.048). Conclusion: 1. Thickening of the intima-media layer of the carotid artery is more prevalent in men than in women. 2. Blood levels of non-HDL-C are highly correlated with carotid artery plaque formation in a population at high risk of stroke.