Is Low Cholesterol a Predisposing Factor for Primary Intracerebral Haemorrhage? A South Indian Perspective
Published: May 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/31402.11479
Sandhya Manorenj, Imran Ahmed Siddiqui, P Muralikrishna, Keshav Anand, Navya Sagari
1. Associate Professor, Department of Neurology, ESIC Super Speciality Center, ESIC Medical College Hospital, Hyderabad, Telangana, India.
2. Assistant Professor, Department of Biochemistry, ESIC Super Speciality Center, ESIC Medical College Hospital, Hyderabad, Telangana, India.
3. Senior Resident, Department of Neurology, ESIC Super Speciality Center, ESIC Medical College Hospital, Hyderabad, Telangana, India.
4. Senior Resident, Department of Neurology, ESIC Super Speciality Center, ESIC Medical College Hospital, Hyderabad, Telangana, India.
5. Medical Officer, Department of Neurology, ESIC Super Speciality Center, ESIC Medical College Hospital, Hyderabad, Telangana, India.
Correspondence
Dr. Imran Ahmed Siddiqui,
Assistant Professor, Department of Biochemistry, ESIC Super Speciality Center, ESIC Medical College Hospital,
Hyderabad-500038, Telangana, India.
E-mail: write2drimran@gmail.com
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.
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