PDF(Pubmed)
Abstract：
UNASSIGNED: Whether the relationship of intracerebral bleeding risk with lipid profile may vary by sex remains unclear. This study aims to investigate potential sex differences in the association between lipid profile and the risk of symptomatic intracerebral hemorrhage (sICH) in patients with acute ischemic stroke (AIS) who received intravenous thrombolysis using recombinant tissue plasminogen activator (r-tPA).
UNASSIGNED: This multicenter retrospective observational study analyzed patients with AIS treated with intravenous r-tPA. sICH was defined as a worsening of 4 or higher points in the National Institutes of Health Stroke Scale (NIHSS) score within 36 hours after intravenous thrombolysis in any hemorrhage subtype. We assessed the odds ratio (OR) with 95% confidence interval (CI) of lipid profile for sICH for each sex using logistic regression models adjusted for potential confounding factors.
UNASSIGNED: Of 957 participants (median age 68 (interquartile range, 59-75), men 628 (65.6%)), 56 sICH events (36 (5.7%) in men and 20 (6.1%) in women) were observed. The risk of sICH in men decreased with increasing serum levels of triglyceride after adjustment for confounding factors (vs lowest tertile, medium tertile OR 0.39, 95% CI [0.17-0.91], top tertile OR 0.33, 95% CI [0.13-0.84], overall p = 0.021; per point increase, adjusted OR 0.29, 95% CI [0.13-0.63], p = 0.002). Neither serum levels of total cholesterol nor low-density lipoprotein (LDL) was associated with sICH in men. In women, there was no association between any of the lipid levels and the risk of sICH.
UNASSIGNED: This study indicated that the association between serum levels of triglyceride and sICH may vary by sex. In men, increased triglyceride levels decrease the risk of sICH; in women, this association was lost. Further studies on the biological mechanisms for sex differences in stroke risk associated with triglyceride are needed.
UNASSIGNED: This multicenter retrospective observational study analyzed patients with AIS treated with intravenous r-tPA. sICH was defined as a worsening of 4 or higher points in the National Institutes of Health Stroke Scale (NIHSS) score within 36 hours after intravenous thrombolysis in any hemorrhage subtype. We assessed the odds ratio (OR) with 95% confidence interval (CI) of lipid profile for sICH for each sex using logistic regression models adjusted for potential confounding factors.
UNASSIGNED: Of 957 participants (median age 68 (interquartile range, 59-75), men 628 (65.6%)), 56 sICH events (36 (5.7%) in men and 20 (6.1%) in women) were observed. The risk of sICH in men decreased with increasing serum levels of triglyceride after adjustment for confounding factors (vs lowest tertile, medium tertile OR 0.39, 95% CI [0.17-0.91], top tertile OR 0.33, 95% CI [0.13-0.84], overall p = 0.021; per point increase, adjusted OR 0.29, 95% CI [0.13-0.63], p = 0.002). Neither serum levels of total cholesterol nor low-density lipoprotein (LDL) was associated with sICH in men. In women, there was no association between any of the lipid levels and the risk of sICH.
UNASSIGNED: This study indicated that the association between serum levels of triglyceride and sICH may vary by sex. In men, increased triglyceride levels decrease the risk of sICH; in women, this association was lost. Further studies on the biological mechanisms for sex differences in stroke risk associated with triglyceride are needed.
摘要：
■脑出血风险与血脂的关系是否因性别而异尚不清楚。本研究旨在探讨使用重组组织型纤溶酶原激活剂（r-tPA）接受静脉溶栓治疗的急性缺血性卒中（AIS）患者的血脂状况与症状性脑出血（sICH）风险之间的潜在性别差异。
■这项多中心回顾性观察性研究分析了静脉r-tPA治疗的AIS患者。sICH定义为任何出血亚型在静脉溶栓后36小时内美国国立卫生研究院卒中量表(NIHSS)评分恶化4分或更高.我们使用逻辑回归模型对潜在的混杂因素进行了校正，评估了每种性别的sICH血脂谱的比值比（OR）和95％置信区间（CI）。
■957名参与者(平均年龄68岁(四分位距，59-75），男性628人(65.6%),观察到56例sICH事件（男性36例（5.7％），女性20例（6.1％））。在校正混杂因素后，随着血清甘油三酯水平的升高，男性sICH的风险降低(与最低三元组相比，中等三分位数或0.39，95%CI[0.17-0.91]，最高三分位数或0.33，95%CI[0.13-0.84]，总体p=0.021；每增加一个点，调整后OR0.29，95%CI[0.13-0.63]，p=0.002)。男性血清总胆固醇和低密度脂蛋白（LDL）水平均与sICH无关。在女性中，任何血脂水平与sICH风险之间均无关联.
■这项研究表明，血清甘油三酯水平与sICH之间的关联可能因性别而异。在男人中，甘油三酯水平升高降低sICH的风险;在女性中，这个协会已经失去了。需要进一步研究与甘油三酯相关的卒中风险性别差异的生物学机制。
■这项多中心回顾性观察性研究分析了静脉r-tPA治疗的AIS患者。sICH定义为任何出血亚型在静脉溶栓后36小时内美国国立卫生研究院卒中量表(NIHSS)评分恶化4分或更高.我们使用逻辑回归模型对潜在的混杂因素进行了校正，评估了每种性别的sICH血脂谱的比值比（OR）和95％置信区间（CI）。
■957名参与者(平均年龄68岁(四分位距，59-75），男性628人(65.6%),观察到56例sICH事件（男性36例（5.7％），女性20例（6.1％））。在校正混杂因素后，随着血清甘油三酯水平的升高，男性sICH的风险降低(与最低三元组相比，中等三分位数或0.39，95%CI[0.17-0.91]，最高三分位数或0.33，95%CI[0.13-0.84]，总体p=0.021；每增加一个点，调整后OR0.29，95%CI[0.13-0.63]，p=0.002)。男性血清总胆固醇和低密度脂蛋白（LDL）水平均与sICH无关。在女性中，任何血脂水平与sICH风险之间均无关联.
■这项研究表明，血清甘油三酯水平与sICH之间的关联可能因性别而异。在男人中，甘油三酯水平升高降低sICH的风险;在女性中，这个协会已经失去了。需要进一步研究与甘油三酯相关的卒中风险性别差异的生物学机制。
