Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, China.
Department of Neurology, First Affiliated Hospital of Jinan University, Guangzhou, China.
Eur J Neurol. 2022 Sep;29(9):2683-2689. doi: 10.1111/ene.15418. Epub 2022 Jun 7.
Intracranial atherosclerotic stenosis (ICAS) is a major cause of stroke in Asian countries. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a hereditary enzyme defect prevalent in Asian countries, has been associated with atherosclerotic cardiovascular disease and worse poststroke outcomes. However, the impact of G6PD deficiency on ICAS remains unclear. We aimed to compare the risk of ICAS in stroke patients with and without G6PD deficiency in a Chinese cohort.
We prospectively and consecutively recruited stroke patients from four centers in China. All patients received intracranial artery assessment by magnetic resonance/computed tomography angiography or digital subtraction angiography, as well as G6PD enzyme evaluation. The prevalence, burden, and characteristics of ICAS were compared between patients with and without G6PD deficiency using multivariate regression analysis.
Among 1593 patients, 116 (63.7%) of 182 patients with G6PD deficiency and 714 (50.6%) of 1411 patients with normal G6PD levels were identified as ICAS. Age, hypertension, diabetes, and G6PD deficiency were independent predictors of ICAS. Among patients with ICAS, G6PD-deficient individuals were more likely to have multiple (≥2 segments) intracranial stenosis (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.25-2.81, p = 0.002). G6PD deficiency increased the risk of ICAS in patients who were male (OR = 1.82, 95% CI = 1.24-2.66, p = 0.002), aged ≥70 years (OR = 2.40, 95% CI = 1.33-4.31, p = 0.004), or hypertensive (OR = 1.88, 95% CI = 1.28-2.77, p = 0.001).
Stroke patients with G6PD deficiency have a higher prevalence and ICAS burden than those with normal G6PD, particularly those who are male, older, and hypertensive.
颅内动脉粥样硬化性狭窄（ICAS）是亚洲国家中风的主要原因。葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症是亚洲国家普遍存在的遗传性酶缺陷，与动脉粥样硬化性心血管疾病和中风后预后较差有关。然而，G6PD 缺乏症对 ICAS 的影响尚不清楚。我们旨在比较中国队列中伴有和不伴有 G6PD 缺乏症的中风患者发生 ICAS 的风险。
我们前瞻性连续招募了来自中国 4 个中心的中风患者。所有患者均接受了磁共振/计算机断层血管造影或数字减影血管造影的颅内动脉评估，以及 G6PD 酶评估。使用多变量回归分析比较了伴有和不伴有 G6PD 缺乏症的患者中 ICAS 的患病率、负担和特征。
在 1593 名患者中，182 名 G6PD 缺乏症患者中有 116 名（63.7%）和 1411 名正常 G6PD 水平患者中有 714 名（50.6%）被确定为 ICAS。年龄、高血压、糖尿病和 G6PD 缺乏症是 ICAS 的独立预测因素。在 ICAS 患者中，G6PD 缺乏症患者更有可能发生多处（≥2 个节段）颅内狭窄（优势比[OR] = 1.87，95%置信区间[CI] = 1.25-2.81，p = 0.002）。G6PD 缺乏症增加了男性（OR = 1.82，95% CI = 1.24-2.66，p = 0.002）、年龄≥70 岁（OR = 2.40，95% CI = 1.33-4.31，p = 0.004）和高血压（OR = 1.88，95% CI = 1.28-2.77，p = 0.001）患者发生 ICAS 的风险。
与正常 G6PD 相比，G6PD 缺乏症的中风患者具有更高的患病率和 ICAS 负担，尤其是男性、年龄较大和高血压患者。
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