Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China.
Int J Environ Res Public Health. 2020 Dec 26;18(1):119. doi: 10.3390/ijerph18010119.
Carotid intima-media thickness (cIMT) has been associated with an elevated risk of ischemic stroke (IS) in several studies, but the results are inconsistent. We investigated whether the association between cIMT and IS varied across different IS subtypes, and further assessed gene-cIMT interactions' association with IS risk.
A total of 1048 IS cases (795 large-artery atherosclerosis (LAA) cases, 103 small-vessel occlusion (SVO) cases, and 150 other subtypes) and 2696 IS-free controls across 2179 families were included in the analysis. Self-reported IS cases were confirmed through medical records' review and head imaging by computed tomography and/or magnetic resonance imaging. The mean values of the common cIMT obtained in bilateral distal and proximal carotid artery segments were used. The genotype information of rs2910164 polymorphism in microRNA-146a (miR-146a) was also collected.
We found that cIMT was significantly associated with a higher risk of IS and LAA subtype but not SVO subtype in the multivariate-adjusted models. The odds ratio (OR) and 95% confidence interval (CI) in the highest quartile versus the lowest quartile of cIMT was 2.48 (1.92-3.20) for IS and 2.75 (2.08-3.64) for LAA (both trend <0.001). The results also showed that there was a significant interaction between cIMT and rs2910164 genotype with the risk of IS ( interaction = 0.03) and LAA ( interaction = 0.02). The associations of cIMT with IS and LAA were strengthened among participants carried rs2910164_GG genotype compared with those with rs2910164_CC genotype.
Our results indicate that higher cIMT levels were significantly associated with IS and LAA subtype but not SVO subtype, and the relations were modified by rs2910164 polymorphism in miR-146a.
多项研究表明，颈动脉内膜-中层厚度（cIMT）与缺血性脑卒中（IS）风险升高相关，但结果不一致。我们研究了 cIMT 与 IS 之间的关联是否因不同的 IS 亚型而有所不同，并进一步评估了基因-cIMT 相互作用与 IS 风险的关联。
共纳入 2179 个家系的 1048 例 IS 病例（795 例大动脉粥样硬化型（LAA），103 例小血管闭塞型（SVO）和 150 例其他亚型）和 2696 例 IS 对照组。通过病历回顾和计算机断层扫描和/或磁共振成像进行头部成像，确认了自我报告的 IS 病例。采用双侧远端和近端颈动脉节段 cIMT 的平均值。还收集了 microRNA-146a（miR-146a）中 rs2910164 多态性的基因型信息。
我们发现，在多变量调整模型中，cIMT 与 IS 和 LAA 亚型的风险显著相关，但与 SVO 亚型无关。cIMT 最高四分位与最低四分位相比，IS 和 LAA 的比值比（OR）和 95%置信区间（CI）分别为 2.48（1.92-3.20）和 2.75（2.08-3.64）（均趋势<0.001）。结果还表明，cIMT 与 rs2910164 基因型与 IS（交互作用=0.03）和 LAA（交互作用=0.02）的风险之间存在显著的相互作用。与携带 rs2910164_CC 基因型的参与者相比，携带 rs2910164_GG 基因型的参与者的 cIMT 与 IS 和 LAA 的相关性更强。
我们的研究结果表明，较高的 cIMT 水平与 IS 和 LAA 亚型显著相关，但与 SVO 亚型无关，并且这种关系受到 miR-146a 中 rs2910164 多态性的修饰。
