Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Haidian District, Beijing, China.
Int J Neurosci. 2024 Sep;134(9):951-957. doi: 10.1080/00207454.2023.2174024. Epub 2023 Feb 3.
Vertebrobasilar dissecting aneurysms (VBDAs) are known to have a poor natural history with high rates of re-bleeding and mortality. There is a strong relation between hyperhomocysteinemia (HHcy) and cerebrovascular disease; we perform a retrospective study within the male of Chinese Han population to explore the association between HHcy and VBDAs.
Eighty-eight male patients with VBDA and Eighty-one male control subjects were evaluated for their serum total homocysteine levels. With multiple logistic regression analysis, the association between HHcy and the risk of VBDAs was estimated. Interaction and stratified analyses were conducted according to age, BMI, smoking status, drinking status, and chronic disease histories. The two-piecewise linear regression model examined the threshold effect.
The multivariate logistic regression analyses revealed a significant association between HHcy and VBDAs (odds ratio (OR) = 2.62; 95% confidence interval (CI), 1.02-6.71) after adjusting for classical vascular risk factors. The relationship was stable in all subgroup analysis. The interactive role was not found in the association between HHcy and VBDAs for the potential risk factor.
In summary, our study provides evidence that HHcy can increases the risk of VBDAs in the male Han Chinese population. Further researches with appropriate study designs including sex differences and aneurysm types are needed to verify this association.
已知椎基底动脉夹层动脉瘤(VBDAs)自然病史较差,再出血率和死亡率较高。高同型半胱氨酸血症(HHcy)与脑血管疾病之间存在密切关系;我们对汉族男性人群进行了一项回顾性研究,以探讨 HHcy 与 VBDAs 之间的关联。
评估了 88 例男性 VBDA 患者和 81 例男性对照者的血清总同型半胱氨酸水平。采用多因素 logistic 回归分析,估计 HHcy 与 VBDAs 风险之间的关联。根据年龄、BMI、吸烟状况、饮酒状况和慢性病史进行交互和分层分析。采用两段线性回归模型检查阈值效应。
多因素 logistic 回归分析显示,在校正经典血管危险因素后,HHcy 与 VBDAs 之间存在显著关联(比值比(OR)=2.62;95%置信区间(CI),1.02-6.71)。在所有亚组分析中,该关系均保持稳定。在 HHcy 与 VBDAs 之间的潜在风险因素的关联中,未发现交互作用。
综上所述,我们的研究提供了证据表明,HHcy 可增加汉族男性发生 VBDAs 的风险。需要进一步进行包括性别差异和动脉瘤类型在内的适当研究设计的研究,以验证这种关联。