Is Low Cholesterol a Predisposing Factor for Primary Intracerebral Haemorrhage? A South Indian Perspective OC11-OC14
Dr. Imran Ahmed Siddiqui,
Assistant Professor, Department of Biochemistry, ESIC Super Speciality Center, ESIC Medical College Hospital,
Hyderabad-500038, Telangana, India.
Introduction: Stroke is an important cause of mortality and morbidity in low-income and middle-income countries like India. Primary Intracerebral Haemorrhage (PICH) refers to Intracerebral Haemorrhage (ICH) in the absence of a single clear underlying lesion. Cholesterol levels are inconsistently associated with risk of ICH.
Aim: To assess their relationship between lipid parameters and PICH.
Materials and Methods: One hundred sixty patients with PICH were retrospectively recruited and compared with apparently healthy subjects. Low cholesterol was defined by Total Cholesterol (TC) <200 mg/dL; Low Density Lipoprotein Cholesterol (LDL-C) <100 mg/dL; High Density Lipoprotein Cholesterol (HDL-C) <40 mg/dL; and Triglyceride (TG) level <150 mg/dL.
Results: Out of 160 patients recruited majority of the patients were males (n=122). Mean age was 53.47±9.33 years. Most frequent risk factor of PICH was hypertension (72.5%). Most common site of bleed was in basal ganglion (n=63). The proportion of PICH patients with low TC was significantly higher than control (81.9% vs. 70%). TG levels and LDL-C were significantly low in PICH compared with controls (p-value<0.0001). Mean TC in PICH was 159 mg/dL vs. 180 mg/dL (p-value<0.0001); Mean TG level was 114 mg/dL vs. 168 mg/dL (p-value<0.0001); Mean LDL-C was 93 mg/dL vs. 119 mg/dL (p-value<0.0001). In a subgroup analysis, among older age (=50 years) mean TC, TG levels and LDL-C were significantly low in PICH group compared to controls (p-value<0.0001). In multivariate analysis presence of low value of TG, LDL-C and TC remained a significant risk factor of PICH. Odds ratio for TG was 5.55 with 95% Confidence Interval (CI) of 3.295 to 9.36; odds ratio for LDL-C was 3.81 with 95% CI of 2.392 to 6.084.
Conclusion: Our present study confirms low cholesterol as risk factor for PICH especially in older individual and both sexes.