van Eldik Maaike J A, Ali Mariam, Rietkerken Stijn, Peters Sanne A E, den Ruijter Hester M, Ruigrok Ynte M
Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Cerebrovasc Dis. 2025 Jun 5:1-5. doi: 10.1159/000546774.
Women are overrepresented in the unruptured intracranial aneurysm (UIA) population, with an overall two-thirds of patients being female. The reasons behind this female preponderance are still unclear. Therefore, we performed a systematic review of clinical risk factors for UIA, with a specific aim of assessing whether these risk factor associations are sex-dependent.
We systematically searched 5 electronic medical databases for all relevant literature up to March 2024. Cohort and case-control studies reporting on the lifestyle factors smoking, alcohol use, hypertension, hypercholesterolemia, physical activity, diabetes, and BMI were included.
We found a total of 21 studies, reporting on 347,907 participants and 8,698 UIA cases, that met our inclusion criteria. However, only one study provided its results stratified by sex, making it impossible to perform sex-stratified analyses.
Our findings illustrate the scarcity of sex-stratified results in studies on risk factors for UIAs. Since knowledge on potential sex differences in UIA could help understand the female predominance, we highlight a need for more sex-stratified research in this field.
未破裂颅内动脉瘤（UIA）患者中女性比例过高，总体上三分之二的患者为女性。这种女性占比过高背后的原因仍不清楚。因此，我们对UIA的临床风险因素进行了系统综述，具体目的是评估这些风险因素关联是否存在性别差异。
我们系统检索了5个电子医学数据库，以获取截至2024年3月的所有相关文献。纳入了报告生活方式因素（吸烟、饮酒、高血压、高胆固醇血症、身体活动、糖尿病和BMI）的队列研究和病例对照研究。
我们共发现21项研究，涉及347,907名参与者和8,698例UIA病例，符合我们的纳入标准。然而，只有一项研究提供了按性别分层的结果，因此无法进行性别分层分析。
我们的研究结果表明，关于UIA风险因素的研究中缺乏性别分层结果。由于了解UIA潜在的性别差异有助于理解女性占比过高的现象，我们强调该领域需要更多的性别分层研究。
