Additive Interaction Between Potentially Modifiable Risk Factors And Ethnicity In The Han, Tujia and Miao Populations With First-Ever Ischemic Stroke

Abstract Background: As a country with one-fifth of the global population, China has had explosive growth in ischemic stroke burden with significant ethnic and geographic disparities. The aim of this study was to examine the relative risk of potentially modifiable risk factors for ischemic stroke among the Han population and two ethnic minorities (Tujia and Miao).Methods: A case-control study was conducted: 324 cases of first-ever IS from the hospitals of the Xiangxi Tujia and Miao Autonomous Prefecture and 394 controls were surveyed using structured questionnaires from communities covering the same area. Univariate and multivariate logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the association between risk factors and ischemic stroke. The additive model was used to study the interaction between the modifiable risk factor and ethnicity in the R software.Results: Higher high-sensitivity C-reactive protein level(OR 50.54, 95%CI 29.76-85.85), higher monthly family income(4.18, 2.40-7.28), increased frequency of hot pot consumption (2.90, 1.21-6.93), diabetes mellitus (2.62, 1.48-4.62), higher apolipoprotein(Apo)B/ApoA1 ratio(2.60, 1.39-4.85), hypertension(2.52, 1.45-4.40) and moderate-intensity physical activity(0.50, 0.28-0.89) were associated with ischemic stroke. There is an additive interaction between ApoB/ApoA1 ratio and ethnicity in Tujia and Miao populations with first-ever ischemic stroke (the relative excess risk due to interaction was 5.75, 95%CI 0.58~10.92; the attributable proportion due to interaction was 0.65, 95%CI 0.38~0.91; the synergy was 3.66, 95%CI 1.35~9.93). Conclusions: It is the first case-control study examining modifiable risk factors for ischemic stroke among the Han population and two ethnic minorities (Tujia and Miao) in China, some differences were observed in the impact of risk factors among these ethnic groups. Our results may help interpret health-related data, including surveillance and research, when developing strategies for stroke prevention.

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Additive interaction between potentially modifiable risk factors and ethnicity among individuals in the Han, Tujia and Miao populations with first-ever ischaemic stroke

BMC Public Health ◽

10.1186/s12889-021-11115-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Zhang ◽

Xinrui Wu ◽

Mengyuan Tian ◽

Xiaolei Wang ◽

Jian Ding ◽

...

Keyword(s):

Risk Factors ◽

Ischaemic Stroke ◽

Ethnic Minorities ◽

Case Control Study ◽

Case Control ◽

Moderate Intensity ◽

Modifiable Risk Factors ◽

Additive Interaction ◽

Han Population ◽

Control Study

Abstract Background As a country with one-fifth of the global population, China has experienced explosive growth in ischaemic stroke (IS) burden with significant ethnic and geographic disparities. The aim of this study was to examine the differences in potentially modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao). Methods A case-control study was conducted with 324 cases of first-ever ischaemic stroke from the hospitals of the Xiangxi Tujia and Miao Autonomous Prefecture and 394 controls from communities covering the same area between May 1, 2018, and April 30, 2019. Structured questionnaires were administered, and physical examinations were performed in the same manner for cases and controls. Univariate and multivariate logistic regression analyses with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were used to examine the association between risk factors and ischaemic stroke. An additive model was used to study the interaction between the modifiable risk factors and ethnicity with R software. Results Higher high-sensitivity C-reactive protein levels (OR 50.54, 95%CI 29.76–85.85), higher monthly family income (4.18, 2.40–7.28), increased frequency of hot pot consumption (2.90, 1.21–6.93), diabetes mellitus (2.62, 1.48–4.62), a higher apolipoprotein (Apo)B/ApoA1 ratio (2.60, 1.39–4.85), hypertension (2.52, 1.45–4.40) and moderate-intensity physical activity (0.50, 0.28–0.89) were associated with ischaemic stroke. There was an additive interaction between the ApoB/ApoA1 ratio and ethnicity in the Tujia and Miao populations with first-ever ischaemic stroke (the relative excess risk due to the interaction was 5.75, 95% CI 0.58 ~ 10.92; the attributable proportion due to the interaction was 0.65, 95% CI 0.38 ~ 0.91; the synergy index was 3.66, 95% CI 1.35 ~ 9.93). Conclusions This is the first case-control study examining modifiable risk factors for ischaemic stroke among the Han population and two ethnic minorities (Tujia and Miao) in China. Some differences were observed in the impact of risk factors among these ethnic groups. Our results may help interpret health-related data, including surveillance and research, when developing strategies for stroke prevention.

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The Auckland Stillbirth study, a case-control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/j.1479-828x.2010.01254.x ◽

2010 ◽

Vol 51 (1) ◽

pp. 3-8 ◽

Cited By ~ 29

Author(s):

Tomasina STACEY ◽

John M.D. THOMPSON ◽

Edwin A. MITCHELL ◽

Alec J. EKEROMA ◽

Jane M. ZUCCOLLO ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Modifiable Risk Factors ◽

Third Trimester ◽

Control Study

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A Case-Control Study of the Association of the Polymorphisms of MTHFR and APOE with Risk Factors and the Severity of Coronary Artery Disease

Cardiology ◽

10.1159/000499866 ◽

2019 ◽

Vol 142 (3) ◽

pp. 149-157 ◽

Cited By ~ 1

Author(s):

Yan Long ◽

Xiao-Tao Zhao ◽

Chang Liu ◽

Yuan-Yuan Sun ◽

Yin-Ting Ma ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Sanger Sequencing ◽

Case Control Study ◽

Case Control ◽

Chinese Han ◽

Han Population ◽

Control Study

Objectives: To explore the association between single-nucleotide polymorphisms (SNPs) in MTHFR and APOE and the risk of CAD and, more importantly, the severity of CAD and the profile of serum lipids, we performed a case-control study in a Chinese Han population. Methods: A total of 1,207 cases of consecutive CAD-suspected inpatients were recruited, and 406 CAD cases and 231 non-CAD controls were enrolled for the final analysis after screening for exclusion criteria. All subjects had undergone coronary angiography, and the severity of CAD was evaluated by 2 cardiologists according to the Gensini scores. The genotypes of MTHFR and APOEwere detected using real-time PCR, and then verified by Sanger sequencing. Environmental risk factors, such as age, sex, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia, and BMI were collected. Statistical analyses (the χ2 test, binary logistic regression analysis, and ordinal polytomous logistic regression analysis) were performed with SPSS v16.0. Results: The genotypes ofall the subjects included in the CAD and non-CAD groups in this study were successfully detected, with an agreement of 100% with Sanger sequencing. The distributions of genotypes CT and TT at MTHFR C667T were higher in CAD cases than in non-CAD controls (OR 1.99, 95% CI 1.34–2.95; OR 1.77, 95% CI 1.18–2.67; p < 0.05), whereas genotype AC at MTHFR A1298Cwas lower in CAD cases (OR 0.71, 95% CI 0.50–1.02; p < 0.05). A significant association was observed in genotypes CT and TT at MTHFR C667T and the risk of CAD (OR 1.44, 95% CI 1.27–3.67; OR 1.56, 95% CI 0.88–2.78; p < 0.05). Both genotypes and alleles of APOE were comparable in the CAD cases and non-CAD controls (p > 0.05). The genotype TT at MTHFR C667T and ε4+ at APOE were more likely to be found in the CAD subgroup with a Gensini score ≥72 (p = 0.040 and p = 0.028, respectively). Meanwhile, in the patients with genotype TT,a higher level of serum Hcy was detected, while genotype ε4+ patients possessed higher levels of serum apolipoprotein E (ApoE) and low-density lipoprotein cholesterol (LDL-C) than other genotypes. Conclusion: This study revealed that the SNP site of MTHFR C667Tis associatedwith the risk of CAD in this Chinese Han population. In addition, the genotypes of TT in MTHFR C667T and ε4+in APOE may increase the severity of CAD, and higher Hcy, LDL-C, and ApoE levels may be involved in this pathogenic process.

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Cerebrovascular risk factors associated with ischemic stroke in a young non-diabetic and non-hypertensive population: a retrospective case-control study

BMC Neurology ◽

10.1186/s12883-020-02005-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Nan Zhang ◽

Lin Zhang ◽

Qiu Wang ◽

Jingwei Zhao ◽

Jia Liu ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Young Adults ◽

Ischemic Stroke ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Retrospective Case ◽

Factors Associated ◽

Control Study

Abstract Background Globally, rates of ischemic stroke (IS) have been rising among young adults. This study was designed to identify risk factors associated with IS incidence in young adults unaffected by hypertension or diabetes. Methods This was a retrospective case-control study of early-onset IS patients without diabetes and hypertension. Control patients were matched with healthy individuals based upon sex, age (±2 years), and BMI (±3 kg/m2) at a 1:3 ratio. Sociodemographic, clinical, and risk factor-related data pertaining to these patients was collected. The association between these risk factors and IS incidence was then assessed using conditional logistic regression models. Results We recruited 60 IS patients and 180 controls with mean ages of 44.37 ± 4.68 and 44.31 ± 4.71 years, respectively, for this study. Relative to controls, IS patients had significantly higher total cholesterol (TG), homocysteine (HCY), white blood cell (WBC), absolute neutrophil count (ANC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels, and significantly lower high-density lipoprotein cholesterol (HDL-C) and triglyceride cholesterol (TC), free triiodothyronine (FT3), and free thyroxine (FT4) levels (all P < 0.05). After controlling for potential confounding factors, HCY and ANC were found to be significantly positively associated with IS incidence (OR 1.518, 95%CI 1.165–1.977, P = 0.002 and OR 2.418, 95%CI 1.061–5.511, P = 0.036, respectively), whereas HDL-C and FT3 levels were negatively correlated with IS incidence (OR 0.001, 95%CI 0.000–0.083, P = 0.003 and OR 0.053, 95%CI 0.008–0.326, P = 0.002, respectively). Conclusions In young non-diabetic and non-hypertensive patients, lower HDL-C and FT3 levels and higher HCY and ANC levels may be associated with an elevated risk of IS. Additional prospective studies of large patient cohorts will be essential to validate these findings.

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The Auckland Stillbirth study, a case–control study exploring modifiable risk factors for third trimester stillbirth: methods and rationale

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/j.yobg.2012.06.137 ◽

2012 ◽

Vol 2012 ◽

pp. 105-106

Author(s):

J.S. Dungan

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Modifiable Risk Factors ◽

Third Trimester ◽

Control Study

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Authors’ Response to Peer Reviews of “Impact of Modifiable Risk Factors on the Occurrence of Cutaneous Leishmaniasis in Diyala, Iraq: Case-Control Study” (Preprint)

10.2196/preprints.31512 ◽

2021 ◽

Author(s):

Asaad Mahdi Lehlewa ◽

Hanan Abdulghafoor Khaleel ◽

Faris Lami ◽

Saif Aldeen Falah Hasan ◽

Hasanain Asmail Malick ◽

...

Keyword(s):

Risk Factors ◽

Cutaneous Leishmaniasis ◽

Peer Review ◽

Case Control Study ◽

Case Control ◽

Modifiable Risk Factors ◽

Peer Reviews ◽

Control Study

UNSTRUCTURED These are author responses to peer review.

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ZSCAN25 and CYP2E1 polymorphisms is risk factors for ischemic stroke in a Chinese Han population: a case control study

10.21203/rs.3.rs-29274/v1 ◽

2020 ◽

Author(s):

Haozheng Yuan ◽

Pei Fan ◽

Li Yao ◽

Yuying Lv ◽

Haidong Wei ◽

...

Keyword(s):

Ischemic Stroke ◽

Odds Ratio ◽

Case Control Study ◽

Case Control ◽

Chinese Han Population ◽

Chinese Han ◽

Han Population ◽

The Relationship ◽

Control Study ◽

Age And Sex

Abstract Background We aimed to explore the relationship between ZSCAN25 and CYP2E1 polymorphisms and Ischemic stroke (IS) susceptibility among a Chinese Han population. Methods We enrolled 477 patients with IS and 480 age- and sex- matched health controls. Genotyping of the ZSCAN25 rs10242455, CYP2E1 rs2070672 and rs2515641 were performed by Agena MassARRAY platform. Odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression analysis. Results Rs10242455 (OR = 0.56, 95% CI: 0.34–0.93, p = 0.024) was associated with a reduced IS susceptibility, while rs2070672 (OR = 1.40, 95% CI: 1.12–1.75, p = 0.003) and rs2515641 (OR = 1.29, 95% CI: 1.01–1.64, p = 0.041) with an increased IS occurrence. Rs2070672 was observed to correlate with IS risk (OR = 4.06, p = 0.038) at age > 64 years, and rs10242455 (OR = 0.45, p = 0.021) and rs2070672 (OR = 3.28, p = 0.024) affected IS risk in males. In addition, rs10242455 (OR = 1.72, p = 0.014) was significantly associated with hypertension in IS patients. Conclusion Our study firstly found that rs10242455 in ZSCAN25, rs2070672 and rs2515641 in CYP2E1 were associated with the occurrence of IS in a Chinese Han population.

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