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Table 1 Summary of studies investigating the relationship between lipid levels and ICH

From: Blood lipid levels, statin therapy and the risk of intracerebral hemorrhage

Study Study design Sample size Study population Mean Age (y); Male (%) Follow-Up in Years Baseline lipid levels(mmol/L) ICH (n) Key study findings
[15] Sturgeon et al. 2007 pooled prospective cohort study (including 2 studies: ARIC and CHS) 21,680 without a history of stroke, American 54.2 (ARIC),72.8 (CHS); 44.8 % (ARIC), 42.4 % (CHS) 3 (ARIC); 5 (CHS) TG: 1.49 (ARIC), 1.58 (CHS); TC: 5.56 (ARIC), 5.46 (CHS); LDL-C: 3.56 (ARIC), 3.36 (CHS); HDL-C: 1.33 (ARIC), 1.40 (CHS) 135 TG RR 0.56 (95 %CI 0.37–0.84); LDL-C (top 1/4 vs. lower 3/4): RR 0.52 (95 %CI 0.31–0.88)
[11] Bonaventure et al. 2009 population-based prospective cohort study 8393 without a history of stroke, French ≥65; 36.8 % 5 TC: 5.56 (TG ≤0.94), 5.81 (TG 0.95–1.3), 6.08 (TG ≥1.34); LDL-C: 1.82 (TG ≤0.94), 1.62 (TG 0.95–1.33), 1.39(TG ≥1.34); HDL-C: 1.82 (TG ≤0.94), 1.62 (TG 0.95–1.33), 1.39 (TG ≥1.34) 36 TG ≤0.94 mmol/L: adjusted HR 2.35 (95 %CI 1.18–4.70)
[16] Wieberdink et al. 2011 prospective cohort study 9068 without a history of stroke, Dutch ≥55; 57.1 % 9.7 TG, median (IQR): 1.3 (1.0–1.8); TC, median (IQR): 5.8 (5.2–6.5); LDL-C, median (IQR): 3.7 (3.2–4.3); HDL-C, median (IQR): 1.3 (1.1–1.6) 85; 162 CMB in 789 healthy participants TG: HR 0.20 (95 %CI 0.06–0.69); TG (CMB): HR 0.37 (95 %CI 0.14–0.96)
[17] Zia et al. 2006 population-based nested case–control study 33,346 (1029 stroke-free controls, matched for age, sex and screening-year) without a history of myocardial infarction or stroke, Swedish 47; 67.3 % 14 / 147 TG (among the lobar ICH): OR 1.7 (95 %CI 0.9–3.2); TG (among the nonlobar ICH):OR 1.4 (95 %CI 0.9–2.3)
[18] Zhou et al. 2003 cross-sectional study 700 without a history of stroke, Chinese ≥57 / / 500 In ICH patients, TG and LDL-C were significantly increased (P < 0.0001), HDL-C was significantly decreased (P < 0.0001)
[13] O’Donnell et al. 2010 case–control study 4317 be admitted to hospital with first acute stroke whose causes were vascular, 22 countries 66.1; 63.0 % 3 / 663 TC OR 0.62 (99 %CI 0.42–0.92); HDL-C OR 1.91 (99 %CI 1.29–2.83); non-HDL-C: 0.50 (99 %CI 0.34–0.72)
[19] Wang et al. 2013 meta-analysis (19 prospective cohort studies, 4 nested case–control studies) 1,430,141 / / / / 7960 high versus low analysis: TC RR 0.69 (95 %CI 0.59–0.81), LDL-C RR 0.62 (95 %CI 0.41–0.92), HDL-C RR 0.98 (95 %CI 0.80–1.19); dose–response analysisa: TC RR 0.85 (95 %CI 0.80–0.91), LDL-C RR 0.90 (95 %CI 0.77–1.05), HDL-C RR 1.11 (95 %CI 0.99–1.25)
[20] Suzuki et al. 2010 prospective cohort study 156,892 without a history of stroke, Japanese 53.3; 48.7 % 3 / 361 low TC (<160 mg/dl) was critical risks of ICH
[2] Romero et al. 2014 prospective cohort study 1965 without a history of stroke, American 66.5; 66.0 % 12 TC, mean (SD): 4.95 (0.96); LDL-C, mean (SD): 2.84 (0.83) 173 TC <10th percentile: 1.91 (95 %CI 1.20–3.03); LDL-C <10th percentile: 1.28 (95 %CI 0.75–2.19)
[12] Zhang et al. 2012 prospective cohort study 58,235 without a history of coronary heart disease or stroke, Finnish 25–74; 47.6 % 20.1 / 497 TC in women: <5 mmol/L HR 1.00, 5–5.9 mmol/L HR 0.58 (95 %CI 0.38–0.90), 6–6.9 mmol/L HR 0.40–0.94 (95 %CI 0.40–0.94), ≥7 mmol/L HR 0.50 (95 %CI 0.32–0.78); the relationship of TC and ICH in men was not significant
[21] Mustanoja et al. 2013 observational registry 964 (187 patients used statin before ICH) Be admitted to hospital with ICH, Finnish 66; 57.1 % / TG, median (IQR): 1.0 (0.7–1.3); TC, median (IQR): 4.4 (3.8–5.1); LDL-C, median (IQR): 2.4 (1.8–3.0); HDL-C, median (IQR):1.4 (1.1.–1.8) 964 After adjusting for known ICH prognostic factors, lower LDL-C was independently associated with in-hospital mortality (OR 0.54, 95 %CI 0.31–0.93)
  1. ARIC the atherosclerosis risk in communities study, CHS the cardiovascular health study, IQR interquartile range, OR odds ratio, CI confidence interval, SD standard deviation, HR hazard ratio, RR relative risk
  2. a for 1 mmol/L increment