Hemoglobin Concentration and Risk of Incident Stroke in Community-Living Adults.
Hemoglobin Concentration and Risk of Incident Stroke in Community-Living Adults.
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DOI：
10.1161/strokeaha.116.013077
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发表时间：
2016-08
期刊：
影响因子：
8.3
通讯作者：
Gutiérrez OM
中科院分区：
文献类型：
--
作者：
Panwar B;Judd SE;Warnock DG;McClellan WM;Booth JN 3rd;Muntner P;Gutiérrez OM
在先前的观察性研究中，血红蛋白浓度与卒中风险增加相关。然而，这些研究受到中风事件数量相对较少的限制，因此难以确定血红蛋白与中风的关联是否因人口统计学或临床因素而不同。我们使用考克斯比例风险分析和Kaplan-Meier图，在卒中地理和种族差异原因（REGARDS）研究中，对基线血红蛋白浓度与卒中事件的相关性进行了研究，该研究是一项年龄≥45岁的黑人和白色成人队列研究。在平均7±2年的随访中，共有518名参与者发生了卒中。血红蛋白和性别（P=0.05）对卒中发生风险的影响具有统计学意义。在调整人口统计学和临床变量的考克斯回归模型中，男性基线血红蛋白浓度与卒中事件无关，而女性基线血红蛋白浓度与卒中事件无关。（<12.4 g/dL）和最高与第二个四分位数相比，血红蛋白四分位数（>14.0 g/dL）与卒中风险较高相关。（12.4 - 13.2 g/dL）（四分位数1，HR 1.59，95%CI 1.09，2.31;四分位数2参考;四分位数3，HR 0.91，95%CI 0.59，1.38;四分位数4，HR 1.59，95%CI 1.08，2.35）。在按血红蛋白和性别分层的模型中，以及当血红蛋白作为连续变量使用限制性二次样条回归建模时，观察到类似的结果。血红蛋白浓度越低和越高，女性发生卒中的风险越高。在男性中没有发现这种关联。
In prior observational studies, hemoglobin concentrations have been associated with an increased risk of stroke. However, these studies were limited by a relatively low number of stroke events, making it difficult to determine whether the association of hemoglobin and stroke differed by demographic or clinical factors. Using Cox proportional hazards analysis and Kaplan-Meier plots, we examined the association of baseline hemoglobin concentrations with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults ≥45 years of age. A total of 518 participants developed stroke over a mean 7±2 years of follow-up. There was a statistically significant interaction between hemoglobin and sex (P=0.05) on the risk of incident stroke. In Cox regression models adjusted for demographic and clinical variables, there was no association of baseline hemoglobin concentration with incident stroke in men, whereas in women, the lowest (<12.4 g/dL) and highest (>14.0 g/dL) quartiles of hemoglobin were associated with higher risk of stroke as compared to the second quartile (12.4 – 13.2 g/dL) (Quartile 1, HR 1.59, 95%CI 1.09,2.31; Quartile 2 referent; Quartile 3, HR 0.91, 95%CI 0.59,1.38; Quartile 4, HR 1.59, 95%CI 1.08,2.35). Similar results were observed in models stratified by hemoglobin and sex and when hemoglobin was modeled as a continuous variable using restricted quadratic spline regression. Lower and higher hemoglobin concentrations were associated with a higher risk of incident stroke in women. No such associations were found in men.