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代谢综合征与无症状脑动脉狭窄的关联:中国山东的一项横断面研究

Association Between Metabolic Syndrome and Asymptomatic Cerebral Arterial Stenosis: A Cross-Sectional Study in Shandong, China.

作者信息

Li Shan, Sun Xiao, Zhao Yuanyuan, Wang Xiang, Ji Xiaokang, Sang Shaowei, Shao Sai, Xiang Yuanyuan, Wang Guangbin, Lv Ming, Xue Fuzhong, Sun Qinjian, Du Yifeng

机构信息

Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

出版信息

Front Neurol. 2021 May 12;12:644963. doi: 10.3389/fneur.2021.644963. eCollection 2021.

Abstract

Metabolic syndrome (MetS) can worsen cerebral arterial atherosclerosis stenosis in patients with stroke; however, its effect on patients without stroke remains ambiguous. This study explored the association of MetS and its individual components with asymptomatic intracranial arterial stenosis (aICAS) and asymptomatic extracranial arterial stenosis (aECAS) among older Chinese adults. A total of 1988 participants from the Kongcun Town study aged ≥40 years and without a history of stroke were enrolled. The baseline data were obtained via face-to-face interviews. MetS was defined according to International Diabetes Federation criteria. Detection of aICAS was conducted using transcranial Doppler ultrasound, followed by diagnosis via magnetic resonance angiography. The evaluation of aECAS was performed using bilateral carotid ultrasonography. The aICAS and aECAS groups were 1:1 matched separately to the non-stenosis group by age and sex. The association between MetS and aICAS or aECAS was analyzed using multivariate logistic regression. Among the 1988 participants, 909 were diagnosed with MetS. The prevalence of MetS was higher in the aICAS group than in the non-stenosis group ( <0.001), but did not differ significantly between the aECAS and non-stenosis groups. The prevalence of aICAS increased with the number of MetS components from 3.4% in the ≤ 1 component group to 12.7% in the ≥4 components group ( for trend <0.001). After adjusting for confounding factors, MetS components associated with aICAS included central obesity, elevated triglyceride levels, and elevated blood pressure. None of the MetS components was associated with aECAS. MetS was positively associated with aICAS, but not with aECAS. Further, different components play different roles in the pathological process leading to aICAS.

摘要

代谢综合征(MetS)可加重中风患者的脑动脉粥样硬化狭窄;然而,其对未患中风患者的影响仍不明确。本研究探讨了中国老年人群中MetS及其各组分与无症状颅内动脉狭窄(aICAS)和无症状颅外动脉狭窄(aECAS)之间的关联。共纳入了1988名来自孔村镇研究的年龄≥40岁且无中风病史的参与者。通过面对面访谈获取基线数据。MetS根据国际糖尿病联盟标准定义。使用经颅多普勒超声检测aICAS,随后通过磁共振血管造影进行诊断。使用双侧颈动脉超声评估aECAS。aICAS组和aECAS组分别按年龄和性别与非狭窄组进行1:1匹配。采用多因素logistic回归分析MetS与aICAS或aECAS之间的关联。在1988名参与者中,909人被诊断为MetS。aICAS组中MetS的患病率高于非狭窄组(<0.001),但aECAS组与非狭窄组之间无显著差异。aICAS的患病率随着MetS组分数量的增加而升高,从≤1个组分组的3.4%增至≥4个组分组的12.7%(趋势P<0.001)。在调整混杂因素后,与aICAS相关的MetS组分包括中心性肥胖、甘油三酯水平升高和血压升高。没有MetS组分与aECAS相关。MetS与aICAS呈正相关,但与aECAS无关。此外,不同组分在导致aICAS的病理过程中发挥不同作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fa3/8149894/712055ca1e73/fneur-12-644963-g0001.jpg

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