Association between serum lipids and apolipoproteins level and chronic subdural hematoma: a case-control study

Abstract Background: Several studies, including a randomized clinical trial, have demonstrated that atorvastatin may be an effective nonoperative treatment for chronic subdural hematoma (CSDH). Atorvastatin is mainly used to regulate lipid metabolism. However, few studies investigated the association between serum lipids level and risk of CSDH.Methods: We conducted a retrospective case-control study to assess the relationship between fasting lipids (total cholesterol, triglyceride, HDL-C and LDL-C), apolipoproteins (ApoA1, ApoB) and risk of CSDH. Using a one-to-three case–control ratio, 137 CSDH patients were included in our study. Conditional logistic regression was used to examine the relationship between lipids and apolipoproteins biomarkers and risk of CSDH.Result: In univariate analysis, baseline levels of total cholesterol (P<0.001), HDL-C (P<0.001) and ApoA1 were significantly lower among patients with CSDH, while levels of ApoB were higher. No significant difference for triglyceride (P=0.15) and LDL-C (P=0.47) were observed. In multivariable analysis, total cholesterol (OR for the highest vs lowest quartile 0.34, 05%CI 0.19-0.64, P<0,001), triglycerides (OR 1.98, 95%CI 1.05-3.71, p<0,05), HDL-C (OR 0.26, 95%CI 0.13-0.52, P<0,001), ApoA1 (OR 0.27, 95%CI 0.14-0.52, P<0,001) were significantly associated with CSDH, when conditioned on age and gender, and adjusted for head trauma and hypertension. Additional adjustment for all covariates of interest don’t substantially change the multivariable associations.Conclusion: Among a panel of lipids and apolipoproteins biomarkers, total cholesterol, triglycerides, HDL-C, ApoA1 were significantly associated with CSDH.