Department of Cardiology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Urinary Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China.
Sci Rep. 2019 Oct 4;9(1):14313. doi: 10.1038/s41598-019-50856-z.
Data on the sex-specific differences in risk of stroke among patients with H-type hypertension are limited. We aimed to analyze interactions between sex and other risk factors on stroke, including the sex-methylenetetrahydrofolate reductase (MTHFR) interaction. A retrospective analysis of baseline data from 2040 patients with hypertension and hyperhomocysteinemia (HHcy) included demographic characteristics, biomarkers, history of chronic diseases and lifestyle factors. Polymerase chain reaction-restriction fragment length polymorphism method was used to investigate the C677T polymorphism of MTHFR gene. We examined independent effects and interactions between sex and stratified factors on the risk of stroke by logistic regression model. A total of 1412 patients suffered stroke, and the prevalence of stroke was 70.65% in men and 66.53% in women. Both men and women had independent risk factors for stroke, including diabetes mellitus, atrial fibrillation, smoking, increased level of systolic blood pressure (SBP) and plasma total homocysteine (tHcy), as well as the decreased level of high-density lipoprotein cholesterol. Diastolic blood pressure (DBP) -specific risk of stroke was unique to men. Interactions between sex and other risk factors on stroke risk were statistically significant: age, fasting plasma glucose (FPG), SBP, DBP, triglycerides (TG) and tHcy. Furthermore, tHcy interacted with age, SBP and DBP in men, and age, SBP, DBP, FPG, and TG in women to modulate the risk of stroke. Although TT genotype did not have an independent effect on stroke, it could interact with sex and FPG, TG and SBP to increase stroke. In conclusion, sex-specific differences are useful to stratify the risk of stroke and assist clinicians in the decision to select a reasonable therapeutic option for high-risk patients.
关于 H 型高血压患者中风风险的性别特异性差异的数据有限。我们旨在分析性别与其他危险因素（包括性别-亚甲基四氢叶酸还原酶（MTHFR）相互作用）对中风的相互作用。对 2040 例高血压和高同型半胱氨酸血症（HHcy）患者的基线数据进行回顾性分析，包括人口统计学特征、生物标志物、慢性病史和生活方式因素。采用聚合酶链反应-限制性片段长度多态性方法检测 MTHFR 基因 C677T 多态性。我们通过 logistic 回归模型检查了性别和分层因素之间的独立作用和相互作用对中风风险的影响。共有 1412 例患者发生中风，男性中风患病率为 70.65%，女性为 66.53%。男性和女性均有独立的中风危险因素，包括糖尿病、心房颤动、吸烟、收缩压（SBP）和血浆总同型半胱氨酸（tHcy）升高以及高密度脂蛋白胆固醇水平降低。舒张压（DBP）特异性中风风险仅存在于男性中。性别与其他危险因素对中风风险的相互作用具有统计学意义：年龄、空腹血糖（FPG）、SBP、DBP、甘油三酯（TG）和 tHcy。此外，tHcy 与男性的年龄、SBP 和 DBP 相互作用，与女性的年龄、SBP、DBP、FPG 和 TG 相互作用，调节中风风险。虽然 TT 基因型对中风没有独立影响，但它可以与性别以及 FPG、TG 和 SBP 相互作用，增加中风的风险。总之，性别特异性差异有助于分层中风风险，并有助于临床医生为高危患者选择合理的治疗方案。
