Lipoprotein(a) as a Risk Factor for Recurrent Ischemic Stroke in Type 2 Diabetes.

IF 2.8 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pub Date : 2025-05-17 eCollection Date: 2025-01-01 DOI:10.2147/DMSO.S502459

Ruomeng Chen, Kun Zhang, Hui Liu, Lijuan Liu, Hui Li, Yan Yan, Zhou Zhou, Chaoyue Meng, Xuelin Wang, Haoran Wu, Ruihan Miao, Rui Wang, Xiaoyun Liu

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Abstract

Objective: This study aimed to investigate the effect of LP(a) on recurrent ischemic stroke among persons with and without diabetes, providing a basis for the precise management of patients with recurrent ischemic stroke with diabetes in clinical practice.

Methods: This study was conducted on consecutive patients with cerebral infarction diagnosed between January 2019 and March 2023 in the Second Hospital of Hebei Medical University. Stratified analyses were performed according to LP(a) level (≤/>90th percentile) and logistic regression modeling was performed to investigate the relationship between LP(a) and recurrent ischemic stroke with or without T2DM.

Results: In the final enrollment of 2029 patients, the number of recurrent ischemic stroke according to LP(a) >90th percentile combined with T2DM was 59.15%, which was significantly higher than in LP(a) ≤90th percentile combined with T2DM (46.17%, P=0.039). After multivariate adjustment, LP(a) >90th percentile emerged as an independent risk factor for patients with T2DM (OR=2.062, 95% CI 1.218-3.489, P=0.007). In patients with large artery atherosclerotic ischemic stroke, LP(a) was an independent risk factor for recurrent ischemic stroke in diabetic patients (OR=2.553, 95%CI 1.385-4.707, P = 0.003), while this was not in non-diabetic patients (P = 0.228).

Conclusion: LP(a) is an independent risk factor for recurrent ischemic stroke in the diabetic population but not in nondiabetic individuals. Simple categorization based on the presence or absence of comorbid T2DM significantly influences the association between LP(a) and recurrent ischemic stroke. Therefore, in clinical practice, for ischemic stroke patients with comorbid diabetes, the LP(a) level should be more strictly controlled.

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脂蛋白(a)是2型糖尿病患者复发性缺血性卒中的危险因素。

目的：本研究旨在探讨LP(a)对糖尿病和非糖尿病患者复发性缺血性脑卒中的影响，为临床对复发性缺血性脑卒中合并糖尿病患者的精准管理提供依据。方法：研究对象为河北医科大学第二医院2019年1月至2023年3月诊断为脑梗死的连续患者。根据LP(a)水平（≤/ bbb90百分位）进行分层分析，采用logistic回归模型探讨LP(a)与伴或不伴T2DM的复发性缺血性卒中的关系。结果：在最终入选的2029例患者中，LP(a)≤90百分位合并T2DM的缺血性卒中复发率为59.15%，明显高于LP(a)≤90百分位合并T2DM的复发率46.17%，P=0.039。多因素调整后，LP(a) bb0第90百分位成为T2DM患者的独立危险因素（OR=2.062, 95% CI 1.218-3.489， P=0.007）。在大动脉粥样硬化性缺血性卒中患者中，LP(a)是糖尿病患者缺血性卒中复发的独立危险因素（OR=2.553, 95%CI 1.385-4.707, P = 0.003），而在非糖尿病患者中则不是（P = 0.228）。结论：LP(a)是糖尿病人群复发性缺血性脑卒中的独立危险因素，但在非糖尿病人群中不是。基于是否合并T2DM的简单分类显著影响LP(a)与复发性缺血性卒中之间的关联。因此，在临床实践中，对于缺血性脑卒中合并糖尿病患者，应更严格地控制LP(a)水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

5.90

自引率

6.10%

发文量

431

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.