Abstract | BACKGROUND: METHODS: Fasting plasma lipids were collected on participants in the Northern Manhattan Study, a prospective cohort study examining risk factors for cardiovascular disease in a multiethnic elderly urban-dwelling population. A subsample of the cohort underwent brain MRI between 2003 and 2008 (a median of 6.2 years, range = 0-14, after enrollment), when repeat fasting lipids were obtained. We used lipid profile components at the time of initial enrollment (n = 1,256 with lipids available) as categorical variables, as well as change in clinical categories over the two measures (n = 1,029). The main outcome measures were (1) total white matter hyperintensity volume (WMHV) using linear regression and (2) silent brain infarcts (SBI) using logistic regression. RESULTS: None of the plasma lipid profile components at the time of enrollment were associated with WMHV. The association between baseline lipids and WMHV was, however, modified by apolipoprotein E ( apoE) status (χ(2) with 2 degrees of freedom, p = 0.03), such that among apoE4 carriers those with total cholesterol (TC) ≥200 mg/dl had a trend towards smaller WMHV than those with TC <200 mg/dl (difference in logWMHV -0.19, p = 0.07), while there was no difference among apoE3 carriers. When examining the association between WMHV and change in lipid profile components we noted an association with change in high-density lipoprotein cholesterol (HDL-C, >50 mg/dl for women, >40 mg/dl for men) and TC. A transition from low-risk HDL-C (>50 mg/dl for women, >40 mg/dl for men) at baseline to high-risk HDL-C at the time of MRI (vs. starting and remaining low risk) was associated with greater WMHV (difference in logWMHV 0.34, p value 0.03). We noted a similar association with transitioning to a TC ≥200 mg/dl at the time of MRI (difference in logWMHV 0.25, p value 0.006). There were no associations with baseline or change in lipid profile components with SBI. CONCLUSIONS: The association of plasma lipid profile components with greater WMHV may depend on apoE genotype and worsening HDL and TC risk levels over time.
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Authors | Joshua Z Willey, Hannah Gardener, Yeseon P Moon, Mitsuhiro Yoshita, Charles DeCarli, Ying Kuen Cheung, Ralph L Sacco, Mitchell S V Elkind, Clinton B Wright |
Journal | Cerebrovascular diseases (Basel, Switzerland)
(Cerebrovasc Dis)
Vol. 37
Issue 6
Pg. 423-30
( 2014)
ISSN: 1421-9786 [Electronic] Switzerland |
PMID | 25034465
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2014 S. Karger AG, Basel. |
Chemical References |
- Apolipoproteins E
- Lipoproteins, HDL
- Lipoproteins, LDL
- Cholesterol
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Aging
- Apolipoproteins E
(genetics)
- Cholesterol
(blood)
- Cohort Studies
- Female
- Humans
- Lipid Metabolism
- Lipoproteins, HDL
(blood)
- Lipoproteins, LDL
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Prospective Studies
- Risk Factors
- Stroke
(etiology, genetics)
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