Glucose-6-phosphate dehydrogenase deficiency and intracranial atherosclerotic stenosis in stroke patients
Glucose-6-phosphate dehydrogenase deficiency and intracranial atherosclerotic stenosis in stroke patients
复制标题
6-磷酸葡萄糖脱氢酶缺乏与脑卒中患者颅内动脉粥样硬化性狭窄
DOI：
10.1111/ene.15418
复制
发表时间：
2022-06-07
影响因子：
5.1
通讯作者：
Zeng，Jinsheng
中科院分区：
文献类型：
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作者：
Li，Jianle;Chen，Yicong;Zeng，Jinsheng
背景和目的颅内动脉粥样硬化性狭窄（ICAS）是亚洲国家中风的主要原因。葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症是亚洲国家普遍存在的一种遗传性酶缺陷，与动脉粥样硬化性心血管疾病和中风后预后较差有关。然而，G6PD 缺乏对 ICAS 的影响仍不清楚。我们的目的是比较中国队列中患有和不患有 G6PD 缺陷的中风患者发生 ICAS 的风险。方法我们前瞻性地连续招募来自中国四个中心的中风患者。所有患者均接受磁共振/计算机断层扫描血管造影或数字减影血管造影的颅内动脉评估，以及G6PD酶评估。采用多变量回归分析比较有和没有G6PD缺乏的患者之间ICAS的患病率、负担和特征。结果在1593名患者中，182名G6PD缺乏患者中的116名（63.7％）和1411名G6PD水平正常的患者中714名（50.6％）被确定为ICAS。年龄、高血压、糖尿病和 G6PD 缺乏是 ICAS 的独立预测因素。在 ICAS 患者中，G6PD 缺陷的个体更有可能出现多发性（≥2 个节段）颅内狭窄（比值比 [OR] = 1.87，95% 置信区间 [CI] = 1.25–2.81，p= 0.002）。 G6PD 缺乏会增加男性 (OR = 1.82, 95% CI = 1.24–2.66,p= 0.002)、年龄 ≥70 岁 (OR = 2.40, 95% CI = 1.33–4.31,p= 0.004) 或高血压患者的 ICAS 风险（OR = 1.88，95% CI = 1.28–2.77，p= 0.001）。结论 G6PD 缺乏的中风患者比 G6PD 正常的中风患者有更高的患病率和 ICAS 负担，特别是那些男性、老年人和高血压患者。
Background and purposeIntracranial atherosclerotic stenosis (ICAS) is a major cause of stroke in Asian countries. Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency, a hereditary enzyme defect prevalent in Asian countries, has been associated with atherosclerotic cardiovascular disease and worse poststroke outcomes. However, the impact of G6PD deficiency on ICAS remains unclear. We aimed to compare the risk of ICAS in stroke patients with and without G6PD deficiency in a Chinese cohort.MethodsWe prospectively and consecutively recruited stroke patients from four centers in China. All patients received intracranial artery assessment by magnetic resonance/computed tomography angiography or digital subtraction angiography, as well as G6PD enzyme evaluation. The prevalence, burden, and characteristics of ICAS were compared between patients with and without G6PD deficiency using multivariate regression analysis.ResultsAmong 1593 patients, 116 (63.7%) of 182 patients with G6PD deficiency and 714 (50.6%) of 1411 patients with normal G6PD levels were identified as ICAS. Age, hypertension, diabetes, and G6PD deficiency were independent predictors of ICAS. Among patients with ICAS, G6PD‐deficient individuals were more likely to have multiple (≥2 segments) intracranial stenosis (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.25–2.81,p= 0.002). G6PD deficiency increased the risk of ICAS in patients who were male (OR = 1.82, 95% CI = 1.24–2.66,p= 0.002), aged ≥70 years (OR = 2.40, 95% CI = 1.33–4.31,p= 0.004), or hypertensive (OR = 1.88, 95% CI = 1.28–2.77,p= 0.001).ConclusionsStroke patients with G6PD deficiency have a higher prevalence and ICAS burden than those with normal G6PD, particularly those who are male, older, and hypertensive.