Associations between Lipid Levels and Intracerebral Hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is a complex medical condition found to be associated with various factors, including advanced age, male gender, Asian ethnicity, tobacco use, hypertension, and chronic renal insufficiency. Despite the aforementioned associations, the relationship between lipid fractions and ICH remains ambiguous and has received limited attention in the literature, particularly with respect to Thai populations. Objective: To investigate the potential association between lipid levels and primary ICH. Materials and Methods: The present study employed a retrospective case-control design and enrolled 314 primary ICH cases presented at Rajavithi Hospital between 2012 and 2022. A control group of 366 subjects was established using an age-matching procedure and computer-generated randomization. Participants with coagulopathies or those receiving anticoagulant therapy were excluded. Statistical analysis was performed using binomial and multivariate logistic regression to evaluate the relationship between ICH and the various factors. Results: The present study identified six factors that were independently associated with ICH through bivariate analysis, including male gender (odd ratio [OR] 2.497, 95% confidence interval [CI] 1.829 to 3.407; p<0.001), systolic blood pressure (SBP) (OR 1.023, 95% CI 1.016 to 1.029; p<0.001), diastolic blood pressure (DBP) (OR 1.050, 95% CI 1.037 to 1.062; p<0.001), total cholesterol (OR 0.994, 95% CI 0.991 to 0.998; p=0.001), high-density lipoprotein cholesterol (HDL) (OR 0.985, 95% CI 0.975 to 0.995; p=0.003), and low-density lipoprotein cholesterol (LDL) (OR 0.994, 95% CI 0.991 to 0.998; p=0.002). Multivariate logistic regression revealed five factors to be associated with ICH, including male gender (adjusted OR 1.904, 95% CI 1.293 to 2.803; p=0.001), elevated SBP (adj. OR 1.024, 95% CI 1.017 to 1.032; p<0.001), elevated DBP (adj. OR 1.051, 95% CI 1.037 to 1.064; p<0.001), decreased total cholesterol levels (adj. OR 0.993, 95% CI 0.988 to 0.997; p=0.001), and decreased LDL (adj. OR 0.994, 95% CI 0.990 to0.999; p=0.010). HDL was found to not be significantly associated with ICH (adj. OR 1.003, 95% CI 0.990 to 1.016; p=0.643). Conclusion: The results of the present study suggest that male gender and elevated levels of SBP and DBP were independently associated with ICH, as were decreased levels of total cholesterol and LDL. Keywords: Lipid; Cholesterol; LDL; HDL; Intracerebral hemorrhage