Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and nutritional engineering, China Agricultural University, Beijing, China.
Front Endocrinol (Lausanne). 2022 Jan 25;12:828286. doi: 10.3389/fendo.2021.828286. eCollection 2021.
Previous studies have shown an association of stroke and brachial ankle pulse wave velocity (baPWV). However, due to limitations on total population size and small numbers of stroke cases, lack of power has prevented further detection among subgroups such as age and laboratory testing.
A total of 19217 participants including 660 incident stroke patients were pooled in the present study. Participants were divided to 2 groups, aged less than 65 years [56.0 (50.0, 61.0)] and aged 65 years or more [70.0 (67.0, 74.0)].
After adjustment for demographic, anthropometric, and laboratory parameters, the incident stroke was positively associated to baPWV in the group aged less than 65 years (OR, 1.16; 95% CI, 1.05-1.28), but not in the older group aged 65 or more. When baPWV was assigned as quartiles, a significant, increased risk of new-onset stroke was found in quartiles 3-4 compared with quartile 1. In addition, the predictive value of baPWV for incident stroke was modified by fasting glucose in participants aged less than 65 years (-interaction = 0.010). An increase in baPWV was strongly, positively associated to new-onset stroke in the subgroup of normal fasting glucose (< 5.6 mmol/L) (OR, 1.34; 95% CI, 1.15 - 1.57), but no effect was seen in the impaired fasting glucose (5.6-7.0 mmol/L) or diabetic fasting glucose (> 7.0 mmol/L) subgroups.
Increased baPWV was significantly associated with new-onset stroke in a hypertensive population aged less than 65 years. Particularly, it is of great importance to monitor baPWV for predicting incident stroke in "relatively healthy" hypertensive patients, i.e. aged less than 65 years with normal fasting glucose.
先前的研究表明，中风与肱踝脉搏波速度（baPWV）有关。然而，由于总人群规模的限制和中风病例数量较少，缺乏力量使得进一步在亚组（如年龄和实验室检查）中进行检测变得困难。
本研究共纳入 19217 名参与者，其中包括 660 例新发中风患者。参与者被分为 2 组，年龄<65 岁[56.0（50.0，61.0）]和年龄≥65 岁[70.0（67.0，74.0）]。
在校正人口统计学、人体测量学和实验室参数后，年龄<65 岁的中风与 baPWV 呈正相关（OR，1.16；95%CI，1.05-1.28），但在年龄≥65 岁的人群中则没有相关性。当 baPWV 被分为四分位数时，与四分位数 1 相比，四分位数 3-4 发现新发生中风的风险显著增加。此外，在年龄<65 岁的参与者中，空腹血糖对 baPWV 预测新发中风的作用有修饰作用（-交互作用=0.010）。在空腹血糖正常（<5.6mmol/L）的亚组中，baPWV 的增加与新发生中风强烈呈正相关（OR，1.34；95%CI，1.15-1.57），而在空腹血糖受损（5.6-7.0mmol/L）或糖尿病空腹血糖（>7.0mmol/L）亚组中则没有效果。
在年龄<65 岁的高血压人群中，baPWV 与新发中风显著相关。特别是，监测 baPWV 对预测“相对健康”的高血压患者（即年龄<65 岁且空腹血糖正常）的中风事件具有重要意义。
