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J Clin Neurol.  2015 Jan;11(1):80-86. 10.3988/jcn.2015.11.1.80.

Low-Density-Lipoprotein Particle Size Predicts a Poor Outcome in Patients with Atherothrombotic Stroke

Affiliations
  • 1Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea. brain930@ewha.ac.kr
  • 2Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Neurology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
  • 4Department of Food and Nutrition and Institute of Health Sciences, Korea University, Seoul, Korea.
  • 5Department of Molecular Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke.
METHODS
Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of > or =3.
RESULTS
The LDL particle size in the 248 patients was 25.9+/-0.9 nm (mean+/-SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p<0.1 in univariate analysis, LDL particle size was independently and inversely associated with stroke severity (NIHSS score > or =5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038).
CONCLUSIONS
The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke.

Keyword

low-density-lipoprotein particle size; lipoprotein; stroke severity; stroke outcome; atherosclerosis

MeSH Terms

Atherosclerosis
Cerebral Arteries
Cerebral Infarction
Constriction, Pathologic
Electrophoresis
Humans
Lipoproteins
National Institutes of Health (U.S.)
Particle Size*
Prognosis
Prospective Studies
Risk Factors
Stroke*
Lipoproteins
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