Estimation of The LDL Subclasses in Ischemic Stroke as A Risk Factor in A Chinese Population

PURPOSE: To clarify the role of LDL subclasses in the occurrence of acute ischemic stroke (AIS) and develop a risk prediction model based on these characteristics to identify high-risk people.METHODS: Five hundred and sixty-six patients with AIS and 197 non-AIS controls were included in this study. Serum lipids and other baseline characteristics including fasting blood glucose (GLU), serum creatinine (Scr), and blood pressure were investigated in relation to occurrence of AIS. The LDL subfractions were classified and measured with the Lipoprint System by a polyacrylamide gel electrophoresis technique.RESULTS: Levels of LDL-3, LDL-4 and LDL-5 subclasses were significantly higher in the AIS group compared to the non-AIS group and lower level of LDL-1 was prevalent in the AIS patients. Consistently, Pearson correlation analysis demonstrated that sd‐LDL levels, especially LDL-3 and LDL-4 levels, were significantly positively correlated with AIS. Furthermore, there is a significant positive correlation between sd-LDL levels and serum lipids including TC, LDL‐C, and TG. Increased LDL-3 and LDL-4 as well as decreased LDL-1 and LDL-2 were correlated to the occurrence of AIS, even in the people with normal LDL-C levels. A new prediction model including 12 variables can accurately predict the AIS risk in Chinese patients (AUC=0.82±0.04).CONCLUSIONS: Levels of LDL subclasses should be considered in addition to serum LDL-C in assessment and management of AIS. A new prediction model based on clinical variables including LDL subtractions can help clinicians identify high‐risk patients for better prevention.