AUTHOR=Wen Chi-Pang , Lee Yi-Che , Sun Yuan-Ting , Huang Chih-Yuan , Tsai Chon-Haw , Chen Po-Lin , Chang Wei-Lun , Yeh Po-Yen , Wei Cheng-Yu , Tsai Ming-Jun , Sun Yu , Lin Chih-Hao , Lee Jiunn-Tay , Lai Ta-Chang , Lien Li-Ming , Lin Mei-Chen , Lin Cheng-Li , Lee June-Han , Wang Hao-Kuang , Hsu Chung Y. , Taiwan Stroke Registry Investigators , Liu Chung-Hsiang , Huang Wei-Shih , Lu Chung-Ta , Tsai Tzung-Chang , Tseng Chun-Hung , Lin Kang-Hsu , Shyn Woei-Cherng , Yang Yu-Wan , Liu Yen-Liang , Cho Der-Yang , Chen Chun-Chung , Hsu Shih-Pin , Chen Han-Jung , Chang Cheng-Sen , Kuo Hung-Chang , Lee Lian-Hui , Tsui Huan-Wen , Tsou Jung-Chi , Wang Yan-Tang , Tai Yi-Cheng , Tsai Kun-Chang , Chen Yen-Wen , Lu Kang , Liliang Po-Chao , Tsai Yu-Tun , Liang Cheng-Loong , Wang Kuo-Wei , Chen Jui-Sheng , Chen Po-Yuan , Chye Cien-Leong , Tzeng Wei-Jie , Wu Pei-Hua , Chen Chih-Hung , Hsieh Han-Chieh , Su Hui-Chen , Lee Yu-Shan , Chi Hsin-Yi , Pan Chou-Hsiung , Chan Po-Chi , Hsu Min-Hsien , Wu Ya-Ying , Huang Zhi-Zang , Shoung Hai-Ming , Lo Yi-Chen , Wang Fu-Hwa , Chen Chien-Chung , Tsai Yu-Tai , Wang Ko-Yi , Huang Tzu-Hsuan , Yang Chao-Nan , Hung Chao-Hsien , Shih Ian , Kao Hsin-Yi , Lu Chien-Jung , Lin Cheng-Huai , Huang Chieh-Cheng , Liu Chang-Hsiu , Chan Hoi-Fong , Chen Ping-Kun , Chiu Pai-Yi , Lin Jiann-Chyun , Hsu Yaw-Don , Denq Jong-Chyou , Peng Giia-Sheun , Hsu Chang-Hung , Lin Chun-Chieh , Yen Che-Hung , Cheng Chun-An , Sung Yueh-Feng , Chen Yuan-Liang , Lien Ming-Tung , Chou Chung-Hsing , Liu Chia-Chen , Yang Fu-Chi , Wu Yi-Chung , Tso An-Chen , Lai Yu-Hua , Chiang Chun-I , Tsai Chia-Kuang , Liu Meng-Ta , Lin Ying-Che , Hsu Yu-Chuan , Yin Jiu-Haw , Chung-JenWang , Kai-ChenWang , Chen Li-Mei , Denq Jong-Chyou , Chiu Hou-Chang , Chen Wei-Hung , Bai Chyi-Huey , Huang Tzu-Hsuan , Lau Chi-Ieong , Wu Ya-Ying , Yeh Hsu-Ling , Chang Anna , Jeng Jiann-Shing , Tang Sung-Chun , Tsai Li-Kai , Yeh Shin-Joe , Lin Ching-Huang , Yen Cheng-Chang , Lin Ruey-Tay , Chen Chun-Hung , Khor Gim-Thean , Chao A-Ching , Lin Hsiu-Fen , Huang Poyin , Lin Huey-Juan , Ke Der-Shin , Chang Chia-Yu , Yeh Poh-Shiow , Lin Kao-Chang , Cheng Tain-Junn , Chou Chih-Ho , Yang Chun-Ming , Shen Hsiu-Chu , Chen An-Chih , Tsai Shih-Jei , Lu Tsong-Ming , Kung Sheng-Ling , Lee Mei-Ju , Chou Hsi-Hsien , Lee Siu-Pak , Sun Ming-Hui , Ke Li-Ying , Sung Sheng-Feng , Ong Cheung-Ter , Wu Chi-Shun , Su Yu-Hsiang , Hung Ling-Chien , Chiang Tsuey-Ru , Lee Mei-Ching , Huang Pai-Hao , Lie Sian-King , Liao Pin-Wen , Chen Jen-Tse , Sun Mu-Chien , Lai Tien-Pao , Chen Wei-Liang , Chen Yen-Chun , Chen Ta-Cheng , Wang Wen-Fu , Lee Kwo-Whei , Chang Chen-Shu , Lai Chien-Hsu , Shih Siao-Ya , Chuang Chieh-Sen , Chen Yen-Yu , Chen Chien-Min , Lin Shinn-Kuang , Su Yu-Chin , Hsiao Cheng-Lun , Yang Fu-Yi , Liu Chih-Yang , Chiang Han-Lin , Fu Ser-Chen , Chang Chun-Yuan , Lin I-sheng , Chien Chung-Hsien , Chang Yang-Chuang , Hsiao Yu-Jen , Fang Chen-Wen , Chen Yu-Wei , Lee Kuo-Ying , Lin Yun-Yu , Li Chen-Hua , Tsai Hui-Fen , Hsieh Chuan-Fa , Yang Chih-Dong , Liaw Shiumn-Jen , Liao How-Chin , Yeh Shoou-Jeng , Hsieh Liang-Po , Lee Yong-Hui , Chen Chung-Wen , Hsu Chih-Shan , Ye-Jian-Jhih , Zhuang Hao-Yu , Pan Yan-Hong , Shih Shin-An , Chen Chin-I , Sung Jia-Ying , Weng Hsing-Yu , Teng Hao-Wen , Lee Jing-Er , Huang Chih-Shan , Chao Shu-Ping , Yuan Rey-Yue , Sheu Jau-Jiuan , Yu Jia-Ming , Ho Chun-Sum , Lin Ting-Chun , Yu Shih-Chieh , Chen Jiunn-Rong , Tsai Song-Yen , Tseng Hung-Pin , Liu Chin-Hsiung , Lin Chun-Liang , Lin Hung-Chih , Chen Pi-Tzu , Hu Chaur-Jong , Chi Nai-Fang , Chan Lung , Chern Chang-Ming , Lin Chun-Jen , Wang Shuu-Jiun , Hsu Li-Chi , Wong Wen-Jang , Lee I-Hui , Yen Der-Jen , Tsai Ching-Piao , Kwan Shang-Yeong , Soong Bing-Wen , Chen Shih-Pin , Liao Kwong-Kum , Lin Kung-Ping , Chen Chien , Shan Din-E , Fuh Jong-Ling , Wang Pei-Ning , Lee Yi-Chung , Yu Yu-Hsiang , Huang Hui-Chi , Tsai Jui-Yao , Wu Ming-Hsiu , Chen Shi-Cheng , Wang Chiung-Yao , Hsu Ming-Chin , Chen Tsang-Shan , Yip Ping-Keung , Wang Vinchi , Kaw-ChenWang , Tsai Chung-Fen , Chen Chao-Ching , Chen Chih-Hao , Liu Yi-Chien , Chen Shao-Yuan , Zhao Zi-Hao , Wei Zhi-Peng , Wu Shey-Lin , Liu Ching-Kuan , Lin Ryh-Huei , Chu Ching-Hua , Yan Sui-Hing , Lin Yi-Chun , Chen Pei-Yun , Hsiao Sheng-Huang , Yip Bak-Sau , Tsai Pei-Chun , Chou Ping-Chen , Kuo Tsam-Ming , Lee Yi-Chen , Chiu Yi-Pin , Tsai Kun-Chang , Liao Yi-Sheng
TITLE=Low-Density Lipoprotein Cholesterol and Mortality in Patients With Intracerebral Hemorrhage in Taiwan
JOURNAL=Frontiers in Neurology
VOLUME=12
YEAR=2022
URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.793471
DOI=10.3389/fneur.2021.793471
ISSN=1664-2295
ABSTRACT=Objective: Lower serum low-density lipoprotein cholesterol (LDL-C) levels are associated with increased intracerebral hemorrhage (ICH) risk. However, reverse causality and residual confounding has not attracted public attention. Therefore, we assessed whether people with LDL-C have increased risk of mortality adjusting for potential confounders using two large Taiwan cohorts.
Methods: The Mei-Jhao (MJ) cohort has 414,372 adults participating in a medical screening program with 378 ICH deaths within 15 years of follow-up (1994–2008). Cox proportional hazards regressions estimated hazard death ratios according to LDL-C levels. We identified 4,606 ICH patients from the Taiwan Stroke Registry (TSR) and analyzed the impact of LDL-C on 3-month mortality.
Results: Low cholesterol (LDL-C <100 mg/dL), found in 1/4 of the MJ cohort, was highly prevalent (36%) among young adults (age 20–39). There was a graded relationship between cholesterol and mortality for ICH [Hazard ratio, 1.56; 95% confidence interval (CI), 1.13–2.16]. Compared with patients with an LDL-C of 110–129 mg/dL in TSR, the risk for mortality was 1.84 (95% CI, 1.28–2.63) with an LDL-C of <100 mg/dL.
Conclusion: Lower serum LDL-C level independently predicts higher mortality after acute ICH. While its causative role may vary, low cholesterol may pose potential harms in Taiwan.