Importance of lipid ratios for predicting intracranial atherosclerotic stenosis

Background: We wished to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population. Methods: We included 658 consecutive patients with ischemic stroke in our cross-sectional study. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated. Results : Ratios of TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I were associated significantly with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Analyses of receiver operating characteristic (ROC) curves revealed the apo B/apo A-I ratio have the highest area under the ROC curve (AUC) value for a lipid level alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for a lipid level alone for identifying ICAS. Conclusion : The ratios of TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C and apo B/apo A-I were related significantly to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be better discriminator for identifying ICAS risk.