Low-density lipoprotein subfraction, carotid artery intima-media thickness, nitric oxide, and tumor necrosis factor alpha are associated with newly diagnosed ischemic stroke

Objectives: Small dense (sd) low-density lipoprotein (LDL), tumor necrosis factor (TNF) alpha (alpha), and nitric oxide (NO) have recently emerged as important stroke risk factors. The aim of the study was to investigate the effects of increased levels of small LDL particle size, TNF-alpha and NO on the developed ischemic stroke and increased carotid artery intima-media thickness (CIMT). Materials and Methods: A total of 29 women and 25 men (a total of 54 ischemic stroke patients) and a similar age group of 50 controls (29 females and 21 males) were included in the study. CIMT, C-reactive protein (CRP), TNF-alpha, NO, and lipid subfraction test of the two groups were measured. Results: The mean LDL particle size was smaller in patients with stroke than in the controls (26.8 +/- 0.31 nm vs. 27.0 +/- 0.31 nm, P = 0.003). sd-LDL, TNF-alpha, NO, CRP, right CIMT, and left CIMT were higher in patients with stroke than in the controls (respectively; 8.2 +/- 7.8 mg/dL vs. 3.3 +/- 3.5 mg/dL, P < 0.001; 75.6 +/- 25.0 pg/mL vs. 65.4 +/- 9.1 pg/mL, P = 0.009; 76.4 +/- 53.3 mu mol/L vs. 41.5 +/- 27.0 mu mol/L, P < 0.001; 1.9 +/- 2.6 mm vs. 0.4 +/- 0.3 mm P < 0.001; 0.97 +/- 0.38 mm vs. 0.83 +/- 0.15 mm, P = 0.007; 1.04 +/- 0.44 mm vs. 0.87 +/- 0.19 mm, P = 0.010). Conclusion: These results show that sd-LDL is independently associated with the incidence of stroke and may be a risk factor in the development of stroke. In addition, TNF-alpha, NO, right CIMT, and left CIMT may be a risk factor in the development of ischemic stroke.