Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Stroke Cerebrovasc Dis. 2023 Oct;32(10):107252. doi: 10.1016/j.jstrokecerebrovasdis.2023.107252. Epub 2023 Aug 25.
Given Mediterranean-style diet (MeDi) reduces risk of cardiovascular events, we hypothesized MeDi may also be protective against intracranial large artery stenosis (ICAS), a common cause of stroke worldwide.
This cross-sectional study included stroke-free participants of the Northern Manhattan Study, a diverse population-based study of stroke risk factors. We represented MeDi continuously (range 0-8) based on enrollment food frequency questionnaires, excluding alcohol consumption. We evaluated ICAS both dichotomously at clinically relevant stenosis severities and continuously as a score (possible range 0-44), summated from stenosis severity scores of major intracranial arteries from time-of-flight magnetic resonance angiography. We used logistic or zero-inflated Poisson regression, adjusting for key confounders.
Among 912 included participants (mean age 64±8 years, 59% female, 65% Hispanic, mean MeDi score 4±1.5), 5% and 8% of participants had ≥50% or ≥70% ICAS, respectively (score median [interquartile range]: 0 [0-2]). Increased MeDi score was inversely associated with ICAS, but did not reach statistical significance (≥50% stenosis odds ratio (OR) [95% confidence interval (CI)]: 0.89 [0.79-1.06]; ≥70% stenosis OR [95% CI]: 0.91 [0.74-1.13]; stenosis score β-estimate [95% CI]: -0.02 [-0.06-0.01]).
In this stroke-free subsample, we did not find a significant association between MeDi and ICAS. We may have been limited by statistical power.
鉴于地中海式饮食（MeDi）可降低心血管事件的风险，我们假设 MeDi 可能对颅内大动脉狭窄（ICAS）也具有保护作用，ICAS 是全球范围内卒中的常见病因。
本横断面研究纳入了北方曼哈顿研究（一项针对卒中危险因素的多样化人群基础研究）中无卒中的参与者。我们根据入组时的食物频率问卷，排除酒精摄入后，连续（范围 0-8）表示 MeDi。我们分别采用二分类法（基于临床相关狭窄严重程度）和连续性评分（可能范围 0-44）评估 ICAS，该评分是基于时间飞跃磁共振血管造影术的主要颅内动脉狭窄严重程度评分的总和。我们采用逻辑回归或零膨胀泊松回归，调整了关键混杂因素。
在 912 名纳入的参与者中（平均年龄 64±8 岁，59%为女性，65%为西班牙裔，平均 MeDi 评分 4±1.5），分别有 5%和 8%的参与者存在≥50%或≥70%的 ICAS（评分中位数[四分位间距]：0[0-2]）。MeDi 评分增加与 ICAS 呈负相关，但未达到统计学显著性（≥50%狭窄的优势比[95%置信区间]：0.89[0.79-1.06]；≥70%狭窄的 OR [95% CI]：0.91 [0.74-1.13]；狭窄评分β估计值[95% CI]：-0.02[-0.06-0.01]）。
在本无卒中的亚组中，我们未发现 MeDi 与 ICAS 之间存在显著关联。我们可能受到了统计效能的限制。
