Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454-1015, USA.
J Stroke Cerebrovasc Dis. 2013 May;22(4):323-8. doi: 10.1016/j.jstrokecerebrovasdis.2011.09.004. Epub 2011 Dec 15.
Height is inversely associated with incident coronary disease and total stroke, but few studies have examined the association between height and intraparenchymal hemorrhage (IPH). We hypothesized that height would be inversely associated with incident IPH in the combined cohorts of the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study.
Data on Caucasian and African American participants were used to estimate the association of height at baseline with incident IPH verified by clinician review of medical records and imaging reports. Sex-specific Cox proportional hazards regression models were used to calculate hazard ratios.
A total of 20,983 participants initially free of stroke (11,788 women and 9195 men) were followed for an average of 15.9 years (standard deviation [SD] 5.1 years). Incident IPH occurred in 115 women and 73 men. Sex, but not age, race, study, or blood pressure, modified the association (P = .03). After adjustment for risk factors (age, systolic blood pressure, triglycerides, low-density lipoprotein cholesterol, fibrinogen, and race), among women, height was significantly inversely associated with incident IPH (hazard ratio [HR] per SD [6.3 cm] was 0.81; 95% confidence interval [CI] 0.66-0.99; P = .04). The HR for tertile 3 vs 1 in women was 0.63 (95% CI 0.37-1.08). Among men, height was not linearly associated with incident IPH (HR per SD [6.7 cm] was 1.09; 95% CI 0.84-1.40; P = .52).
This large prospective study provides evidence that shorter height may be a risk factor for incident IPH in women.
身高与冠心病和总卒中的发病呈负相关,但很少有研究探讨身高与脑实质内出血(intraparenchymal hemorrhage,IPH)的关系。我们假设,在动脉粥样硬化风险社区研究(Atherosclerosis Risk in Communities Study)和心血管健康研究(Cardiovascular Health Study)的联合队列中,身高与脑实质内出血发病呈负相关。
本研究使用白种人和非裔美国人的数据,通过临床医生对病历和影像学报告的审查来验证,以评估基线时身高与经证实的脑实质内出血发病的相关性。使用性别特异性 Cox 比例风险回归模型来计算风险比。
共有 20983 名最初无卒中的参与者(女性 11788 名,男性 9195 名),平均随访时间为 15.9 年(标准差 5.1 年)。115 名女性和 73 名男性发生了脑实质内出血事件。性别,但不是年龄、种族、研究或血压,改变了这种相关性(P =.03)。在校正了危险因素(年龄、收缩压、甘油三酯、低密度脂蛋白胆固醇、纤维蛋白原和种族)后,在女性中,身高与脑实质内出血发病呈显著负相关(每标准差(6.3cm)的风险比为 0.81;95%置信区间为 0.66-0.99;P =.04)。女性 tertile 3 与 tertile 1 的风险比为 0.63(95%置信区间 0.37-1.08)。在男性中,身高与脑实质内出血发病无线性相关性(每标准差(6.7cm)的风险比为 1.09;95%置信区间为 0.84-1.40;P =.52)。
这项大型前瞻性研究提供了证据表明,身材矮小可能是女性脑实质内出血发病的一个危险因素。