Kim Young-Suk, Hong Jin-Woo, Jung Woo-Sang, Park Seong-Uk, Park Jung-Mi, Cho Sung-Il, Bu Young-min, Moon Sang-Kwan
Department of Cardiovascular and Neurologic Disease, College of Oriental Medicine, Kyung Hee University, Seoul, Korea.
Gend Med. 2011 Feb;8(1):14-22. doi: 10.1016/j.genm.2011.01.001.
Gender is known to be one of the factors linked to differences in cardiovascular morbidity and mortality. However, little information is available regarding gender differences in the risk factors for intracranial cerebral atherosclerosis (ICAS).
This study investigated the risk factors for ICAS separately by gender in an asymptomatic population.
We collected data from a consecutive series of 935 subjects who had no history of stroke and who had undergone transcranial Doppler ultrasonography (TCD). For each subject, their medical history was documented and tests for biochemical markers were performed. Multiple logistic regression analyses were separately conducted to assess the risk factors associated with ICAS by gender.
The risk factors for asymptomatic ICAS were determined for every 10-year increase in age (odds ratio [OR] = 1.74, 95% confidence interval [CI] = 1.23-2.46), diabetes mellitus (DM) (OR = 3.45, 95% CI = 1.49-7.95), smoking (OR = 2.09, 95% CI = 1.01-4.32), and hypercholesterolemia (OR = 3.31, 95% CI = 1.15-9.50) for male subjects; risk factors female subjects included hypertension (OR = 2.10, 95% CI = 1.40-3.15) and DM (OR = 2.45, 95% CI = 1.11-5.44). An additional stratified analysis indicated that there was no significant risk factor for male subjects aged <50 years, whereas hypertension (OR = 2.90, 95% CI = 1.57-5.37) was the significant risk factor for female subjects aged <50 years. For male subjects aged ≥50 years, DM (OR = 6.00, 95% CI = 1.87-19.20), hypercholesterolemia (OR = 4.72, 95% CI = 1.05-21.19), and every 10-year increase in age (OR = 4.33, 95% CI = 2.02-9.28) were significant risk factors for asymptomatic ICAS, whereas DM (OR = 2.93, 95% CI = 1.14-7.48) was significant for female subjects aged ≥50 years.
The findings suggest that the risk factors for asymptomatic ICAS differ between sexes, indicating a possible role of sex hormones in the development of ICAS.
已知性别是与心血管发病率和死亡率差异相关的因素之一。然而，关于颅内脑动脉粥样硬化（ICAS）危险因素的性别差异，目前可用信息较少。
本研究在无症状人群中按性别分别调查ICAS的危险因素。
我们收集了连续935例无卒中病史且接受过经颅多普勒超声检查（TCD）的受试者的数据。记录每位受试者的病史并进行生化标志物检测。分别进行多因素逻辑回归分析，以评估按性别划分的与ICAS相关的危险因素。
男性受试者中，无症状ICAS的危险因素为年龄每增加10岁（比值比[OR]=1.74，95%置信区间[CI]=1.23 - 2.46）、糖尿病（DM）（OR = 3.45，95% CI = 1.49 - 7.95）、吸烟（OR = 2.09，95% CI = 1.01 - 4.32）和高胆固醇血症（OR = 3.31，95% CI = 1.15 - 9.50）；女性受试者的危险因素包括高血压（OR = 2.10，95% CI = 1.40 - 3.15）和DM（OR = 2.45，95% CI = 1.11 - 5.44）。进一步的分层分析表明，年龄<50岁的男性受试者没有显著的危险因素，而年龄<50岁的女性受试者中高血压（OR = 2.90，95% CI = 1.57 - 5.37）是显著的危险因素。对于年龄≥50岁的男性受试者，DM（OR = 6.00，95% CI = 1.87 - 19.20）、高胆固醇血症（OR = 4.72，95% CI = 1.05 - 21.19）和年龄每增加10岁（OR = 4.33，95% CI = 2.02 - 9.28）是无症状ICAS的显著危险因素，而对于年龄≥50岁的女性受试者，DM（OR = 2.93，95% CI = 1.14 - 7.48）是显著的危险因素。
研究结果表明，无症状ICAS的危险因素存在性别差异，提示性激素在ICAS发生发展中可能起作用。
