James Michael L, Langefeld Carl D, Sekar Padmini, Moomaw Charles J, Elkind Mitchell S V, Worrall Bradford B, Sheth Kevin N, Martini Sharyl R, Osborne Jennifer, Woo Daniel
From the Brain Injury Translational Research Center, Department of Anesthesiology, and Department of Neurology (M.L.J.), Duke University, Durham; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Department of Neurology and Rehabilitation Medicine (P.S., C.J.M., J.O., D.W.), University of Cincinnati, OH; Department of Neurology, College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Division of Neurocritical Care & Emergency Neurology, Department of Neurology (K.N.S.), Yale University, New Haven, CT; and Department of Neurology (S.R.M.), Baylor College of Medicine, Houston, TX.
Neurology. 2017 Sep 5;89(10):1011-1019. doi: 10.1212/WNL.0000000000004255. Epub 2017 Jul 14.
OBJECTIVE: Because age affects hormonal production differently in women compared with men, we sought to define sex and age interactions across a multiracial/ethnic population after intracerebral hemorrhage (ICH) to uncover evidence that loss of gonadal hormone production would result in loss of the known neuroprotective effects of gonadal hormones. METHODS: Clinical and radiographic data from participants in the Ethnic/Racial Variations of Intracerebral Hemorrhage study and the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study prior to December 2013 were used. Relationships among sex, age, and outcome after ICH in 616 non-Hispanic black, 590 Hispanic, and 868 non-Hispanic white participants were evaluated using multivariable logistic regression analysis. Poor outcome was defined as modified Rankin Scale score ≥3 at 90 days after ICH. RESULTS: Sex differences were found in multiple variables among the racial/ethnic groups, including age at onset, premorbid neurologic status, and neurologic outcome after ICH. Overall, no sex-age interaction effect was found for mortality ( = 0.183) or modified Rankin Scale score ( = 0.378) at 90 days after ICH. In racial/ethnic subgroups, only the non-Hispanic black cohort provided possible evidence of a sex-age interaction on 90-day modified Rankin Scale score ( = 0.003). CONCLUSION: Unlike in ischemic stroke, there was no evidence that patient sex modified the effect of age on 90-day outcomes after ICH in a large multiracial/ethnic population. Future studies should evaluate biological reasons for these differences between stroke subtypes. CLINICALTRIALSGOV IDENTIFIER: NCT01202864.
目的：由于年龄对女性和男性激素分泌的影响不同，我们试图确定脑出血（ICH）后不同种族/族裔人群中的性别与年龄的相互作用，以揭示性腺激素分泌减少会导致性腺激素已知的神经保护作用丧失的证据。 方法：使用2013年12月之前脑出血种族/族裔差异研究和出血性中风遗传与环境风险因素研究参与者的临床和影像学数据。采用多变量逻辑回归分析评估616名非西班牙裔黑人、590名西班牙裔和868名非西班牙裔白人参与者脑出血后的性别、年龄和结局之间的关系。不良结局定义为脑出血后90天时改良Rankin量表评分≥3分。 结果：在种族/族裔群体的多个变量中发现了性别差异，包括发病年龄、病前神经功能状态和脑出血后的神经功能结局。总体而言，脑出血后90天时，在死亡率（P = 0.183）或改良Rankin量表评分（P = 0.378）方面未发现性别 - 年龄交互作用。在种族/族裔亚组中，只有非西班牙裔黑人群体提供了90天改良Rankin量表评分存在性别 - 年龄交互作用的可能证据（P = 0.003）。 结论：与缺血性中风不同，在一个大型多种族/族裔人群中，没有证据表明患者性别会改变年龄对脑出血后90天结局的影响。未来的研究应评估这些中风亚型之间差异的生物学原因。 临床试验注册编号：NCT01202864。
Stroke Vasc Neurol. 2021-12
Neuroendocrinology. 2016
Neuroendocrinology. 2016
PLoS One. 2013-11-27
Transl Stroke Res. 2012-3-16
Eur Neuropsychopharmacol. 2012-1-4
Zotero 插件