颈围与缺血性脑卒中风险的关联及其性别差异：来自中国东北地区的多阶段、基于人群的横断面研究。

Incremental significance and sex discrepancies of neck circumference on the odds of ischaemic stroke: a multistage, population-based, cross-sectional study from Northeast China.

机构信息

Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.

Department of Medical Record Management Center, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.

出版信息

BMJ Open. 2022 Mar 30;12(3):e056932. doi: 10.1136/bmjopen-2021-056932.

DOI:10.1136/bmjopen-2021-056932

PMID:35354632

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8969053/

Abstract

OBJECTIVES

Accumulated evidence suggests that neck circumference (NC) is associated with cardiometabolic risk factors. However, limited studies are available regarding the association between NC or height normalised NC (neck-to-height ratio (NHR)) and risk of ischaemic stroke (IS) in the Chinese population. Therefore, we aimed at examining the associations between NC or NHR and odds of IS and exploring the discrepancies between men and women.

DESIGN

A multistage cluster cross-sectional study.

SETTING

A population-based study carried out in Northeast China.

METHODS

A cross-sectional study was undertaken in Northeast China between September 2017 and March 2019, involving 7236 men and 11 352 women, respectively. The median age of participants was 60.30 years, ranging from 40 to 97 years. The associations between NC or NHR and odds of IS were calculated using multiple logistic regression models. Dose-response relationships were depicted using restricted cubic spline functions. Reclassification analyses were carried out to determine the incremental significance of NC or NHR on the odds of IS.

RESULTS

In women, NC and NHR were significantly associated with the odds of IS, independent of traditional risk factors and other anthropometric parameters for obesity. The highest quartile of NC and NHR had a 1.60 (95% CI 1.16 to 2.22)-and 1.72 (95% CI 1.23 to 2.41) times higher odds of IS compared with the lowest quartile. Furthermore, the odds of IS increased by 1.10 (95% CI 1.01 to 1.20) and 1.12 (95% CI 1.02 to 1.22) times per 1 SD increase in NC and NHR, respectively. Reclassification analyses showed that the proportion of correct classification increased by 11.5% (95% CI 2.2% to 20.7%) and 22.8% (95% CI 13.5% to 32.0%) after the addition of NC or NHR into established models, respectively. However, the findings could not be replicated in men.

CONCLUSION

NC and NHR might be promising independent indicators for women IS. Their incremental value in the risk stratification of IS enables the individualised prevention of IS in women.

摘要

目的

越来越多的证据表明颈围（NC）与心血管代谢危险因素有关。然而，关于中国人的 NC 或身高标准化 NC（颈高比（NHR））与缺血性中风（IS）风险之间的关联，相关研究有限。因此，我们旨在研究 NC 或 NHR 与 IS 发病风险的相关性，并探讨男性和女性之间的差异。

设计

多阶段聚类横断面研究。

地点

在中国东北地区进行的一项基于人群的研究。

方法

2017 年 9 月至 2019 年 3 月期间，在中国东北地区进行了一项横断面研究，分别纳入了 7236 名男性和 11352 名女性。参与者的中位年龄为 60.30 岁，年龄范围为 40 岁至 97 岁。使用多因素逻辑回归模型计算 NC 或 NHR 与 IS 发病风险的比值比（OR）。采用限制性立方样条函数描绘剂量-反应关系。进行再分类分析以确定 NC 或 NHR 对 IS 发病风险的增量意义。

结果

在女性中，NC 和 NHR 与 IS 的发病风险显著相关，独立于传统危险因素和其他肥胖的人体测量参数。与最低四分位相比，NC 和 NHR 最高四分位的 IS 发病风险分别高出 1.60（95%置信区间 1.16 至 2.22）和 1.72（95%置信区间 1.23 至 2.41）倍。此外，NC 和 NHR 每增加 1 SD，IS 的发病风险分别增加 1.10（95%置信区间 1.01 至 1.20）和 1.12（95%置信区间 1.02 至 1.22）倍。再分类分析表明，在加入 NC 或 NHR 后，模型的正确分类比例分别增加了 11.5%（95%置信区间 2.2%至 20.7%）和 22.8%（95%置信区间 13.5%至 32.0%）。然而，这些发现不能在男性中复制。