The Neurologist. 22(4):107–115, JUL 2017
DOI: 10.1097/NRL.0000000000000126
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PMID: 28644250
Issn Print: 1074-7931
Publication Date: 2017/07/01
Cholesterol Levels and Hemorrhagic Stroke Risk in East Asian Versus Non-East Asian Populations: A Systematic Review and Meta-Analysis
Liang Xie;Wei Wu;Jin Chen;Jianglong Tu;Jun Zhou;Xueliang Qi;Xiaoping Yin;
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*Department of Neurology, the Second Affiliated Hospital of Nanchang University, Nanchang†Department of Neurology, the First Affiliated Hospital of Chongqing Medical University‡Chongqing Key Laboratory of Neurobiology§Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
Abstract
The aim of this work was to evaluate the relationships between cholesterol levels and risk of hemorrhagic stroke [including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH)] in East Asian versus non-East Asian populations.Relevant prospective studies were identified from systematic searches of PubMed and EMBASE. A random-effects model was used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) that were used to compare the relationships between cholesterol levels and risk of hemorrhagic stroke in East Asian versus non-East Asian populations.In terms of overall hemorrhagic stroke risk, both East Asians and non-East Asians displayed no significant difference between high versus low total cholesterol (TC) (RR=1.26, 95% CI, 0.92-1.72; I2=74.4%, P<0.001; RR=1.69, 95% CI, 1.15-2.49; I2=92.4%, P<0.001, respectively). In terms of ICH risk, East Asians displayed no significant difference between high versus low TC (RR=1.30, 95% CI, 0.89-1.90; I2=78.6%, P<0.001), whereas non-East Asians displayed a significant difference between high versus low TC with low TC showing a higher ICH risk (RR=1.70, 95% CI, 1.08-2.67; I2=91.2%, P<0.001). With respect to SAH risk, East Asians displayed a significant difference between high versus low TC with low TC showing a higher SAH risk (RR=1.48, 95% CI, 1.057-2.08; I2=0%, P=0.682), whereas non-East Asians displayed no significant difference between high versus low TC (RR=1.14, 95% CI, 0.56-2.31; I2=89.9%, P<0.001).Under low cholesterol conditions, East Asian ethnic status favors SAH development, whereas non-East Asian ethnic status favors ICH development.
