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Dyslipidaemia among diabetic patients with ischemic stroke in a Chinese hospital

Chinese Medical Journal 2009年第21期122卷 2567-2572页

作者： WANG Shao-hua SUN Zi-lin RUAN Xiong-zhong GUO Yi-jing WANG Yao JIN Hui YUAN Yang WEI Qiong Department of Endocrinology Affiliated Zhongda Hospital of Southeast University Nanjing Jiangsu 210009 China Department of Neurology Affiliated Zhongda Hospital of Southeast University Nanjing Jiangsu 210009 China Centre for Nephrology Royal Free and University College Medical School University College London Royal Free Campus London UK

Background Dyslipidaemia is a potential independent The aim of this study was to investigate dyslipidaemia, with ischemic stroke in a Chinese hospital. risk factor for cerebrovascular disease in patients with diabetes. treatment and control of dyslipidaemia among diabetic patients Methods A total of 1046 type 2 diabetic patients were assigned to diabetes with （n=-522） and diabetes without stroke groups. The two groups were matched by gender, age and diabetes duration. Lipid and lipoprotein profile were measured. Serum level and control of lipids were assessed and classified according to American Diabetes Association （ADA） guidelines and an intensified low density lipoprotein-cholesterol （LDL-C） target recommended in Chinese dyslipidaemia control criteria. Results Diabetic patients suffering stroke displayed not only poorly-controlled lipid and lipoprotein profiles, including the significantly lower proportion of patients achieving intensified LDL-C target of 〈2.07 mmol/L （80 mg/dl）, and high density lipoprotein-cholesterol （HDL-C） target （14.4% vs 21.0%, P=0.005; 45.8% vs 51.9%, P=0.048 respectively）, but also less adherence to therapy prescribed for dyslipidaemia （30.8% vs 41.0%, P=0.001）, when compared with diabetic patients without stroke. For the diabetic women with stroke, situation of dyslipidaemia was worse, with significantly lower serum level of HDL-C and apoA1, higher LDL-C level and higher ratio of apoB/apoA1 when compared with diabetic counterparts without stroke. Conclusions Many diabetic patients with ischemic stroke remain uncontrolled for dyslipidaemia. Intensified LDL-C and overall lipid lowering clinical goals are potential precautions taken against ischemic stroke among diabetic patients in China.

关键词： stroke, ischemic diabetes dyslipidaemia low density lipoprotein-cholesterol high density lipoprotein-cholesterol triglyceride

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