Dwivedi Alok K, Jang David, Belkin Ofek, Aickareth Justin, Renteria Mellisa, Hawwar Majd, Croft Jacob, Kalas M Ammar, Zuckerman Marc, Zhang Jun
Departments of Molecular and Translational Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
Departments of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA.
Diagnostics (Basel). 2025 Apr 30;15(9):1144. doi: 10.3390/diagnostics15091144.
Cerebral cavernous malformations (CCMs) are neurological disorders that increase the risk of hemorrhagic stroke. The Mexican Hispanic population has a higher prevalence of both CCMs and metabolic syndrome (MetS), defined by the presence of three or more of the following: central obesity, elevated triglycerides, low HDL, dyslipidemia, hypertension, or elevated fasting glucose. MetS is also associated with an increased risk of hemorrhagic stroke. However, the connection between MetS and hemorrhagic stroke in Hispanic CCM patients remains uncertain. Additionally, it is unclear if Hispanic CCM patients have different cardiometabolic profiles compared to controls. We analyzed a retrospective cohort of Mexican Hispanic adult CCM patients, including age- and gender-matched controls from the NHANES database. Fisher's exact test or an unpaired Student's -test was used to compare risk factors between the CCM cohort and controls. Additionally, we conducted relative risk regression analysis to assess the adjusted association of MetS with hemorrhagic stroke. The CCM cohort showed higher rates of epilepsy (24.6% vs. 1.6%, < 0.001) and hemorrhagic stroke (36.6% vs. 3.6%, < 0.001), but a lower prevalence of MetS (14% vs. 54.8%, < 0.001) compared to age- and gender-matched Mexican Hispanic controls. The adjusted analysis revealed that among CCM patients in the older age group (age ≥ 50 years), MetS was associated with hemorrhagic stroke (RR = 2.38, 95%CI: 1.40-4.02, = 0.001). This study reveals distinct features of CCMs in the Mexican Hispanic population, indicating a higher risk of hemorrhagic stroke and epilepsy compared to other ethnic groups. To mitigate the risk of hemorrhagic stroke, controlling blood pressure and managing comorbidities like metabolic syndrome (MetS) and epilepsy are essential, particularly in CCM patients aged 50 years and above.
脑海绵状血管畸形(CCMs)是一种会增加出血性中风风险的神经系统疾病。墨西哥裔西班牙人群中CCMs和代谢综合征(MetS)的患病率较高,代谢综合征的定义为存在以下三种或更多情况:中心性肥胖、甘油三酯升高、高密度脂蛋白降低、血脂异常、高血压或空腹血糖升高。MetS也与出血性中风风险增加有关。然而,西班牙裔CCM患者中MetS与出血性中风之间的联系仍不确定。此外,尚不清楚西班牙裔CCM患者与对照组相比是否具有不同的心脏代谢特征。我们分析了一组墨西哥裔西班牙成年CCM患者的回顾性队列,包括来自美国国家健康与营养检查调查(NHANES)数据库中年龄和性别匹配的对照组。采用Fisher精确检验或非配对t检验比较CCM队列与对照组之间的风险因素。此外,我们进行了相对风险回归分析,以评估MetS与出血性中风的校正关联。与年龄和性别匹配的墨西哥裔西班牙对照组相比,CCM队列的癫痫发病率(24.6%对1.6%,P<0.001)和出血性中风发病率(36.6%对3.6%,P<0.001)更高,但MetS的患病率更低(14%对54.8%,P<0.001)。校正分析显示,在老年CCM患者(年龄≥50岁)中,MetS与出血性中风相关(相对风险RR=2.38,95%置信区间CI:1.40 - 4.02,P=0.001)。这项研究揭示了墨西哥裔西班牙人群中CCMs的独特特征,表明与其他种族相比,其出血性中风和癫痫的风险更高。为降低出血性中风风险,控制血压以及管理代谢综合征(MetS)和癫痫等合并症至关重要,尤其是在50岁及以上的CCM患者中。