Rist Pamela M, Jiménez Monik C, Rexrode Kathryn M
From the Division of Preventive Medicine (P.M.R, M.C.J., K.M.R.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; and Department of Epidemiology (P.M.R.), Harvard T.H. Chan School of Public Health, Boston, MA.
Neurology. 2017 Jun 6;88(23):2176-2182. doi: 10.1212/WNL.0000000000004006. Epub 2017 May 10.
To determine whether elevated β-microglobulin (B2M) levels were associated with an increased risk of incident ischemic stroke events among women.
We performed a nested case-control study among women enrolled in the Nurses' Health Study who provided blood samples between 1989 and 1990 and were free of prior stroke and cancer. We measured B2M levels in 473 ischemic strokes cases confirmed by medical record review and in 473 controls matched 1:1 to the cases on age, race, date of blood collection, menopausal status, postmenopausal hormone use, and smoking status. We analyzed the association between B2M and ischemic stroke using multivariable conditional logistic regression to adjust for traditional stroke risk factors.
Median levels of B2M were higher among cases (1.86 mg/L) than controls (1.80 mg/L, = 0.009, Wilcoxon rank-sum test). Women in the highest B2M quartile had a multivariable-adjusted increased risk of ischemic stroke compared to those in the lowest quartile (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.02-2.39). Results were similar when restricted to those without evidence of chronic kidney disease (estimated glomerular filtration rate ≥60 mL·min·1.73 m) (OR 1.49, 95% CI 1.08-2.06). In an exploratory analysis, the association between B2M and thrombotic stroke was similar to the overall ischemic stroke results, but no association was observed for embolic stroke risk.
High levels of B2M were associated with an increased risk of ischemic stroke among women.
确定β-微球蛋白(B2M)水平升高是否与女性发生缺血性中风事件的风险增加相关。
我们在参加护士健康研究的女性中进行了一项巢式病例对照研究,这些女性在1989年至1990年间提供了血液样本,且既往无中风和癌症病史。我们通过病历审查确认了473例缺血性中风病例的B2M水平,并选取了473名对照,这些对照在年龄、种族、采血日期、绝经状态、绝经后激素使用情况和吸烟状态方面与病例1:1匹配。我们使用多变量条件逻辑回归分析B2M与缺血性中风之间的关联,以调整传统的中风危险因素。
病例组的B2M中位数水平(1.86mg/L)高于对照组(1.80mg/L,P = 0.009,Wilcoxon秩和检验)。与B2M四分位数最低的女性相比,B2M四分位数最高的女性发生缺血性中风的多变量调整风险增加(优势比[OR]为1.56,95%置信区间[CI]为1.02 - 2.39)。当仅限于无慢性肾病证据(估计肾小球滤过率≥60 mL·min·1.73 m²)的人群时,结果相似(OR为1.49,95% CI为1.08 - 2.06)。在一项探索性分析中,B2M与血栓性中风之间的关联与总体缺血性中风结果相似,但未观察到与栓塞性中风风险的关联。
B2M水平升高与女性缺血性中风风险增加相关。