Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group.
Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group.
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DOI：
10.1016/j.jns.2009.03.033
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发表时间：
2009-09-15
影响因子：
4.4
通讯作者：
Ovbiagele, Bruce
中科院分区：
文献类型：
--
作者：
Bang, Oh Young;Saver, Jeffrey L.;Liebeskind, David S.;Pineda, Sandra;Yun, Susan W.;Ovbiagele, Bruce
症状性大动脉粥样硬化（LAA）卒中的血管定位因未知原因而因种族而异。代谢综合征（MetSD）与较高的动脉粥样硬化性卒中风险相关，并包含因种族而异的异常危险因素。因此，我们通过在不同种族群体中检查MetSD与症状性颅内外动脉粥样硬化的关系，来研究MetSD是否可能导致LAA卒中的种族差异。我们分析了4年期间缺血性卒中/TIA患者的前瞻性数据。独立血管危险因素与颅内和颅外LAA与非LAA机制的相关性在两组中按种族分层进行评估；白人和非白人（西班牙裔、非裔美国人和亚裔）。1167例患者符合研究标准。颅内LAA在非白人中比白人更普遍（20.4%比9.6%，P<0.001），而颅外LAA在白人中比非白人更常见（10.7%比7.5%,P = 0.267）。与非LAA组相比，颅内和颅外LAA组中MetSD的存在更为普遍：颅内和颅外LAA组或白人和非白人之间MetSD的患病率无显著差异。然而，随着异常代谢成分数量的增加，白人更容易发生颅外LAA，而非白人更容易发生颅内LAA。校正协变量后，白人患者的MetSD与颅外LAA相关（OR, 1.98; 95% CI, 1.13-3.45），而非白人患者的颅内LAA与MetSD相关（OR, 1.80; 95% CI, 0.97-3.32）。非白人患者的MetSD与颅外LAA无关联，白人患者的MetSD与颅外LAA无关联。我们的研究结果显示，MetSD对头颈动脉粥样硬化分布的影响因种族而异。这一发现可能部分解释了众所周知的不同种族对颅内或颅外动脉粥样硬化的偏好差异。
Vascular localization of symptomatic large artery atherosclerotic (LAA) stroke differs for unknown reasons by race-ethnicity. The metabolic syndrome (MetSD) is associated with higher atherosclerotic stroke risk and comprises abnormal risk factors that can vary by race. Thus, we investigated whether MetSD may contribute to race-ethnic differences in LAA stroke by examining the association of MetSD with symptomatic intra- and extracranial atherosclerosis among a diverse race-ethnic group. We analyzed data prospectively collected over a 4-year period on subjects with ischemic stroke/TIA. Independent vascular risk factor associations with intracranial and extracranial LAA vs. non-LAA mechanism were evaluated in two groups stratified by race-ethnicity; whites and non-whites (Hispanics, African-American, and Asian-American). 1167 patients met study criteria. Intracranial LAA was more prevalent in non-whites vs. whites (20.4% vs. 9.6%, P<0.001), while extracranial LAA had a more frequent point value in whites compared to non-whites (10.7% vs. 7.5%, P = 0.267). The presence of MetSD was more prevalent in both intracranial and extracranial LAA group than in non-LAA group: no significant differences were observed in the prevalence of MetSD between intra vs. extracranial LAA or whites vs. non-whites. However, with increasing numbers of abnormal metabolic components, whites were more likely to have experienced extracranial LAA, whereas non-whites were more likely to have experienced intracranial LAA. After adjusting for covariates, MetSD was associated with extracranial LAA in whites (OR, 1.98; 95% CI, 1.13-3.45), while there was a tendency that intracranial LAA was associated with MetSD in non-whites (OR, 1.80; 95% CI, 0.97-3.32). No association was found between MetSD and extracranial LAA in non-whites and between this syndrome with intracranial LAA in whites. Our results showed that the impact of MetSD on the distribution of cervicocephalic atherosclerosis differed by race-ethnicity. This finding may in part explain the well-known differences in race-ethnic predilection to intracranial or extracranial atherosclerosis.
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影响因子：
8.3
作者：
SACCO, RL;KARGMAN, DE;ZAMANILLO, MC
通讯作者：
ZAMANILLO, MC
影响因子：
8.3
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Lee, LJ;Kidwell, CS;Saver, JL
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Saver, JL
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通讯作者：
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Litt, B