Plasma magnesium and risk of ischemic stroke among women.
Plasma magnesium and risk of ischemic stroke among women.
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DOI：
10.1161/strokeaha.114.005917
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发表时间：
2014-10
期刊：
影响因子：
8.3
通讯作者：
Rexrode KM
中科院分区：
文献类型：
--
作者：
Adebamowo SN;Jiménez MC;Chiuve SE;Spiegelman D;Willett WC;Rexrode KM
较低的血浆镁水平可能与高血压和内皮功能障碍有关，但对中风的前瞻性数据很少。护士健康研究的32,826名参与者在1989-1990年间提供了血液样本，通过2006年的医疗记录确定并确认了缺血性中风事件。我们对459例病例进行了巢式病例-对照分析，在年龄、种族/民族、吸烟状况、抽血日期、禁食状况、更年期状况和激素使用方面与对照组1:1匹配。我们使用条件logistic回归模型来估计血浆镁与缺血性卒中及缺血性卒中亚型风险的多变量校正相关性。中位镁水平在缺血性卒中患者和对照组之间没有差异（中位值为0.86 mmol/l， p值为0.14）。在匹配因素的条件下，镁含量最低五分位数的女性与镁含量最高五分位数的女性相比，总缺血性卒中的相对风险（RR）为1.34（95%可信区间[CI]: 0.86-2.10， p趋势=0.13）。对危险因素和混杂因素的额外调整并没有实质性地改变总的缺血性卒中的风险估计。与镁水平≥0.82 mmol/l的女性相比，镁水平<0.82 mmol/l的女性发生缺血性卒中（多变量RR=1.57; 95% CI: 1.09-2.27, p=0.01）和血栓性卒中（多变量RR=1.66; 95% CI: 1.03-2.65, p=0.03）的风险显著增加。年龄、体重指数、高血压或糖尿病均未观察到明显的影响。较低的血浆镁水平可能会增加女性缺血性中风的风险。
Lower plasma magnesium levels may be associated with higher blood pressure and endothelial dysfunction, but sparse prospective data are available for stroke. Among 32,826 participants in the Nurses’ Health Study who provided blood samples in 1989–1990, incident ischemic strokes were identified and confirmed by medical records through 2006. We conducted a nested case-control analysis of 459 cases, matched 1:1 to controls on age, race/ethnicity, smoking status, date of blood draw, fasting status, menopausal status and hormone use. We used conditional logistic regression models to estimate the multivariable adjusted association of plasma magnesium and the risk of ischemic stroke and ischemic stroke subtypes. Median magnesium levels did not differ between ischemic stroke cases and controls (median=0.86 mmol/l for both; p-value=0.14). Conditional on matching factors, women in the lowest magnesium quintile had a relative risk (RR) of 1.34 (95% confidence interval [CI]: 0.86–2.10, p trend=0.13) for total ischemic stroke, compared to women in the highest quintile. Additional adjustment for risk factors and confounders did not substantially alter the risk estimates for total ischemic stroke. Women with magnesium levels <0.82 mmol/l, had significantly greater risk of total ischemic stroke (multivariable RR=1.57; 95% CI: 1.09–2.27, p=0.01), and thrombotic stroke (multivariable RR=1.66; 95% CI: 1.03–2.65, p=0.03) compared to women with magnesium levels ≥0.82 mmol/l. No significant effect modification was observed by age, body mass index, hypertension or diabetes. Lower plasma magnesium levels may contribute to higher risk of ischemic stroke among women.