LDL phenotype B and other lipid abnormalities in patients with large vessel disease and small vessel disease

J Neurol Sci. 2003 Oct 15;214(1-2):11-6. doi: 10.1016/s0022-510x(03)00166-7.


Background and purpose: Controversies concerning the significance of lipid abnormalities in stroke come mostly from the researches that studied lipid profile without considering stroke aetiologies. We investigated the prevalence of LDL phenotype B and other lipid abnormalities in stroke survivors with large vessel disease (LVD) or small vessel disease (SVD) (TOAST criteria) and in control subjects (CS).

Methods: We studied 30 patients with LVD and 41 patients with SVD screened out of 585 stroke patients and 30 CS who fulfilled the following exclusion criteria: cardiac disorders, renal or hepatic failure, diabetes mellitus, or treatment with lipid-lowering agents. At least 3 months after stroke, the concentrations of total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TGs), apolipoprotein E (apoE), and lipoprotein (a) [lp(a)] were measured and LDL phenotypes and apoE isoforms were identified.

Results: Patients with LVD had significantly higher concentrations of LDL-C than CS (p<0.05). They had higher concentrations of TGs and lower concentrations of HDL-C than patients with SVD and CS (p<0.05). LDL phenotype B was more frequent in patients with LVD (63.3%) than in patients with SVD (39.0%) or in CS (16.7%) (p<0.05). The concentration of apoE was higher in patients with LVD than in patients with SVD or in CS (p<0.05). The percentage of patients with increased level of lp(a) (i.e., >30 mg/ml) was greater in patients with LVD (36.7%) than in CS (10%) (p<0.05).

Conclusions: Patients with stroke due to LVD, but not SVD, have high prevalence of atherogenic lipid abnormalities, including increased frequency of LDL phenotype B and higher percentage of increased lp(a) level, like patients with other atherogenic diseases.

MeSH terms

  • Aged
  • Apolipoproteins E / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / epidemiology
  • Brain Ischemia / genetics
  • Cerebral Arteries / pathology
  • Cerebral Arteries / physiopathology
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood*
  • Cholesterol, LDL / genetics
  • Female
  • Humans
  • Hyperlipidemias / blood*
  • Hyperlipidemias / epidemiology
  • Hyperlipidemias / genetics
  • Intracranial Arteriosclerosis / blood*
  • Intracranial Arteriosclerosis / epidemiology
  • Intracranial Arteriosclerosis / genetics
  • Lipoprotein(a) / blood
  • Male
  • Middle Aged
  • Phenotype
  • Prevalence
  • Risk Factors
  • Stroke / blood*
  • Stroke / epidemiology
  • Stroke / genetics
  • Triglycerides / blood


  • Apolipoproteins E
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Lipoprotein(a)
  • Triglycerides
  • Cholesterol