School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China; School of Public Health, Nantong University, Nantong, China.
J Stroke Cerebrovasc Dis. 2024 Sep;33(9):107870. doi: 10.1016/j.jstrokecerebrovasdis.2024.107870. Epub 2024 Jul 14.
The aim of this study was to investigate the prospective associations between plasma branched-chain amino acids (BCAAs) and the risk of ischemic stroke in men and women.
We conducted a nested case-control study within a community-based cohort in China. The cohort consisted of 15,926 participants in 2013-2018. A total of 321 ischemic stroke cases were identified during the follow up and individually matched with 321 controls by date of birth (±1 year) and sex. Females accounted for 55.8% (n = 358, 179 cases vs 179 controls) of the study population. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between plasma BCAAs and ischemic stroke risk by conditional logistic regression.
Elevated plasma isoleucine was associated with a higher risk of ischemic stroke in women. The OR for the highest compared to the lowest quartile was 2.22 (95% CI: 1.11-4.44, P trend = 0.005) after adjustment for body mass index, education attainment, smoking, hypertension, renal function, menopause and physical activity. A similar association was found for total BCAAs (adjusted OR = 2.03, 95% CI: 1.05-3.95, P trend = 0.04). In contrast, no significant association of plasma BCAAs with ischemic stroke risk was observed in men.
Plasma isoleucine and total BCAAs were significantly associated with ischemic stroke risk in women, but not in men, highlighting sex differences in BCAAs metabolism and stroke pathogenesis.
本研究旨在探讨男性和女性血浆支链氨基酸（BCAAs）与缺血性卒中风险的前瞻性关联。
我们在中国进行了一项基于社区的队列内巢式病例对照研究。该队列由 2013-2018 年间的 15926 名参与者组成。在随访期间共发现 321 例缺血性卒中病例，并按出生日期（±1 年）和性别与 321 名对照进行个体匹配。研究人群中女性占 55.8%（n=358，179 例病例与 179 例对照）。采用条件 logistic 回归计算比值比（OR）和 95%置信区间（CI），以评估血浆 BCAAs 与缺血性卒中风险之间的关联。
血浆异亮氨酸水平升高与女性缺血性卒中风险增加相关。与最低四分位相比，最高四分位的 OR 为 2.22（95%CI：1.11-4.44，P 趋势=0.005），校正体重指数、受教育程度、吸烟、高血压、肾功能、绝经和体力活动后。总 BCAAs 也存在类似的相关性（调整 OR=2.03，95%CI：1.05-3.95，P 趋势=0.04）。相比之下，血浆 BCAAs 与男性缺血性卒中风险无显著关联。
血浆异亮氨酸和总 BCAAs 与女性缺血性卒中风险显著相关，但与男性无关，这突出了 BCAAs 代谢和卒中发病机制中的性别差异。
