Surg Neurol Int. 2015 Oct 23;6:S543-8. doi: 10.4103/2152-7806.168067. eCollection 2015.
Serum lipid profile spectrum and delayed cerebral ischemia following subarachnoid hemorrhage: Is there a relation?.
Surgical neurology international
Sivashanmugam Dhandapani, Ashish Aggarwal, Anirudh Srinivasan, Rajesh Meena, Sachin Gaudihalli, Harnarayan Singh, Manju Dhandapani, Kanchan K Mukherjee, Sunil K Gupta
Affiliations
Affiliations
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
- Department of Neurosurgery, Neuro-nursing Division, National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
PMID: 26664869
PMCID: PMC4653325 DOI: 10.4103/2152-7806.168067
Abstract
BACKGROUND: Serum lipid abnormalities are known to be important risk factors for vascular disorders. However, their role in delayed cerebral ischemia (DCI), the major cause of morbidity after subarachnoid hemorrhage (SAH) remains unclear. This study was an attempt to evaluate the spectrum of lipid profile changes in SAH compared to matched controls, and their relation with the occurrence of DCI.
METHODS: Admission serum lipid profile levels were measured in patients of SAH and prospectively studied in relation to various factors and clinical development of DCI.
RESULTS: Serum triglyceride (TG) levels were significantly lower among SAH patients compared to matched controls (mean [±standard deviation (SD)] mg/dL: 117.3 [±50.4] vs. 172.8 [±89.1], P = 0.002), probably because of energy consumption due to hypermetabolic response. Patients who developed DCI had significantly higher TG levels compared to those who did not develop DCI (mean [±SD] mg/dL: 142.1 [±56] vs. 111.9 [±54], P = 0.05). DCI was noted in 62% of patients with TG >150 mg/dL, compared to 22% among the rest (P = 0.01). Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and lipoprotein (a) neither showed a significant difference between SAH and controls and nor any significant association with DCI. Multivariate analysis using binary logistic regression adjusting for the effects of age, sex, systemic disease, World Federation of Neurosurgical Societies grade, Fisher grade, and clipping/coiling, revealed higher TG levels to have significant independent association with DCI (P = 0.01).
CONCLUSIONS: Higher serum TG levels appear to be significantly associated with DCI while other lipid parameters did not show any significant association. This may be due to their association with remnant cholesterol or free fatty acid-induced lipid peroxidation.
Keywords: Cholesterol; delayed cerebral ischemia; lipid; remnant cholesterol; subarachnoid hemorrhage; triglyceride
References
- Clin Chem. 1972 Jun;18(6):499-502 - PubMed
- Biochim Biophys Acta. 2012 May;1821(5):858-66 - PubMed
- Stroke. 2012 Mar;43(3):691-6 - PubMed
- Arterioscler Thromb Vasc Biol. 2001 Dec;21(12):2026-31 - PubMed
- Circulation. 2013 Sep 17;128(12):1298-309 - PubMed
- Asian J Neurosurg. 2012 Jan;7(1):17-20 - PubMed
- Acta Neurol Scand. 2012 Jun;125(6):382-8 - PubMed
- Cochrane Database Syst Rev. 2013 Apr 30;(4):CD008184 - PubMed
- Ann Neurosci. 2015 Apr;22(2):78-80 - PubMed
- No To Shinkei. 1989 Jan;41(1):67-72 - PubMed
- Arq Bras Cardiol. 2014 Jul;103(1):76-84 - PubMed
- J Clin Neurosci. 2005 Jun;12(5):538-41 - PubMed
- Clin Chem. 2015 Mar;61(3):533-43 - PubMed
- J Neurosurg. 2007 Dec;107(6):1092-100 - PubMed
- Circulation. 2009 Feb 24;119(7):931-9 - PubMed
- JAMA. 2001 May 16;285(19):2486-97 - PubMed
- Lancet. 2014 Aug 16;384(9943):607-17 - PubMed
- Neurosurgery. 1980 Jan;6(1):1-9 - PubMed
- Neurology. 1999 Sep 22;53(5):982-8 - PubMed
- Lancet Neurol. 2009 May;8(5):453-63 - PubMed
- Vasc Health Risk Manag. 2010 Mar 03;6:73-85 - PubMed
- Lancet. 2014 Aug 16;384(9943):618-25 - PubMed
- Stroke. 2010 Oct;41(10 ):2391-5 - PubMed
- J Neurol Neurosurg Psychiatry. 1988 Nov;51(11):1457 - PubMed
- Surg Neurol Int. 2011 Mar 14;2:29 - PubMed
- J Clin Neurosci. 2014 May;21(5):745-50 - PubMed
- Acta Neurochir (Wien). 2013 Feb;155(2):237-46 - PubMed
- Neurol India. 2015 Jul-Aug;63(4):531-6 - PubMed
- Acta Neurochir (Wien). 2015 Mar;157(3):399-407 - PubMed
- Stroke. 2005 Sep;36(9):2024-6 - PubMed
- Lancet. 2014 Aug 16;384(9943):626-35 - PubMed
- Stroke. 2008 Mar;39(3):943-50 - PubMed
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