{"title":"高密度和非高密度脂蛋白胆固醇与颅内出血风险的联合关联：一项队列研究","authors":"Shuting Liu, Wenjun Zhu, Linhao Liu, Jingbo Yang, Hangkuan Liu, Linjie Li, Tianqi Yang, Xixi Tao, Xin Zhou, Qing Yang","doi":"10.1155/ane/8754603","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>The combined impact of different lipid fractions on intracranial hemorrhage (ICH) risk remains underexplored, particularly in high-risk populations.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study examined the joint association of high-density lipoprotein cholesterol (HDL-C) and nonhigh-density lipoprotein cholesterol (non-HDL-C) with ICH risk and identify high-risk combinations in patients receiving direct oral anticoagulants (DOACs).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted a retrospective cohort study of 21,392 patients newly initiating DOAC therapy, using data from the Tianjin Health and Medical Data Platform. Multivariable Cox regression and restricted cubic spline analyses were employed. The joint association of HDL-C and non-HDL-C was visualized using heat maps.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 21,392 included patients (median age 68.0 years; 51% male), restricted cubic spline analyses revealed a linear inverse association for HDL-C and a nonlinear association for non-HDL-C with ICH risk. Joint analysis demonstrated that the risk of ICH increased progressively with decreasing levels of both lipids, particularly when both were low concurrently.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Concurrent low levels of HDL-C and non-HDL-C were associated with higher ICH risk, suggesting that comprehensive lipid assessment may aid in risk stratification.</p>\n </section>\n </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2026 1","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8754603","citationCount":"0","resultStr":"{\"title\":\"Joint Association of High-Density and Nonhigh-Density Lipoprotein Cholesterol With Risk of Intracranial Hemorrhage: A Cohort Study\",\"authors\":\"Shuting Liu, Wenjun Zhu, Linhao Liu, Jingbo Yang, Hangkuan Liu, Linjie Li, Tianqi Yang, Xixi Tao, Xin Zhou, Qing Yang\",\"doi\":\"10.1155/ane/8754603\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>The combined impact of different lipid fractions on intracranial hemorrhage (ICH) risk remains underexplored, particularly in high-risk populations.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This study examined the joint association of high-density lipoprotein cholesterol (HDL-C) and nonhigh-density lipoprotein cholesterol (non-HDL-C) with ICH risk and identify high-risk combinations in patients receiving direct oral anticoagulants (DOACs).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We conducted a retrospective cohort study of 21,392 patients newly initiating DOAC therapy, using data from the Tianjin Health and Medical Data Platform. Multivariable Cox regression and restricted cubic spline analyses were employed. The joint association of HDL-C and non-HDL-C was visualized using heat maps.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 21,392 included patients (median age 68.0 years; 51% male), restricted cubic spline analyses revealed a linear inverse association for HDL-C and a nonlinear association for non-HDL-C with ICH risk. Joint analysis demonstrated that the risk of ICH increased progressively with decreasing levels of both lipids, particularly when both were low concurrently.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Concurrent low levels of HDL-C and non-HDL-C were associated with higher ICH risk, suggesting that comprehensive lipid assessment may aid in risk stratification.</p>\\n </section>\\n </div>\",\"PeriodicalId\":6939,\"journal\":{\"name\":\"Acta Neurologica Scandinavica\",\"volume\":\"2026 1\",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2026-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ane/8754603\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Neurologica Scandinavica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/ane/8754603\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Neurologica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ane/8754603","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Joint Association of High-Density and Nonhigh-Density Lipoprotein Cholesterol With Risk of Intracranial Hemorrhage: A Cohort Study
Background
The combined impact of different lipid fractions on intracranial hemorrhage (ICH) risk remains underexplored, particularly in high-risk populations.
Objective
This study examined the joint association of high-density lipoprotein cholesterol (HDL-C) and nonhigh-density lipoprotein cholesterol (non-HDL-C) with ICH risk and identify high-risk combinations in patients receiving direct oral anticoagulants (DOACs).
Methods
We conducted a retrospective cohort study of 21,392 patients newly initiating DOAC therapy, using data from the Tianjin Health and Medical Data Platform. Multivariable Cox regression and restricted cubic spline analyses were employed. The joint association of HDL-C and non-HDL-C was visualized using heat maps.
Results
Among 21,392 included patients (median age 68.0 years; 51% male), restricted cubic spline analyses revealed a linear inverse association for HDL-C and a nonlinear association for non-HDL-C with ICH risk. Joint analysis demonstrated that the risk of ICH increased progressively with decreasing levels of both lipids, particularly when both were low concurrently.
Conclusion
Concurrent low levels of HDL-C and non-HDL-C were associated with higher ICH risk, suggesting that comprehensive lipid assessment may aid in risk stratification.
期刊介绍：
Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.
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