Fasting Serum Apolipoprotein B48 Is a Risk Factor for Large Artery Atherosclerotic Stroke (P5.233)

Objective: To explore the relationship between fasting serum apolipoprotein B48 and the occurrence of ischemic stroke. Background Low-density lipoprotein cholesterol (LDL) is the primary lipid target for vascular risk reduction in ischemic stroke patients, but emerging data suggest that postprandial hypertriglyceridemia is better predict vascular hazard. Postprandial hypertriglyceridemia mainly refers to the postprandial accumulation of chylomicrons and chylomicron remnants (CM-R). So we investigated the correlation between CM-R accumulation and the prevalence of ischemic stroke. Methods Data prospectively collected over a 1-year period on subjects admitted with ischemic stroke to our center were analyzed. An age and gender matched healthy population served as a control group. Apolipoprotein B48 values were considered to be high when they were in the highest quartile of all values in the study. Independent associations of fasting serum apolipoprotein B48 with ischemic stroke were evaluated. Results A cohort of 378 ischemic stroke patients and 378 controls were enrolled. High apolipoprotein B48 values were more common in stroke patients than in control patients (32.0[percnt] vs. 18[percnt], p<0.05), when 4.2 ug/ml (>75th percentile) was used as the cutoff value. Multivariable analyses indicated that apolipoprotein B48 was a risk factor for stroke, with an odds ratio of 2.04 (p=0.047). The apolipoprotein B48 level was higher in the large artery atherosclerosis subgroup (4.5±3.6 ug/ml) than in any other stroke subgroup (small vessel occlusion, 3.9±2.9 ug/ml; cardioembolism, 2.7±1.7 mg/ml; stroke of undetermined etiology, 3.1±2.1 ug/ml). Conclusions: We have found an association between high apolipoprotein B48 levels and ischemic stroke, and in particular large artery atherosclerotic stroke. Study supported by a grant from Health Department of Sichuan Province (No.110570)