scholarly journals Risk Factors Associated with Ischemic Stroke in a Young Non-Diabetic and Non-Hypertensive Population: A Retrospective Case-Control Study

2020 ◽  
Author(s):  
Nan Zhang ◽  
Lin Zhang ◽  
Qiu Wang ◽  
Jingwei Zhao ◽  
Jia Liu ◽  
...  

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).Conclusion: 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.

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nan Zhang ◽  
Lin Zhang ◽  
Qiu Wang ◽  
Jingwei Zhao ◽  
Jia Liu ◽  
...  

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.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S184-S184
Author(s):  
Patrick O’Neil ◽  
Patrick Ryscavage ◽  
Kristen A Stafford

Abstract Background The incidence of systemic hypertension (HTN) among perinatally-HIV-infected (PHIV) patients appears to increase as they enter adulthood. Among non-perinatally HIV-infected adults both traditional and HIV-associated risk factors have been found to contribute to HTN. Whether these same factors contribute to HTN in PHIV is unknown. The purpose of this study was to determine the socio-demographic, clinical, virologic, and immunologic factors associated with HTN among a cohort of PHIV adolescents and young adults, aged ≥18 years. Methods We conducted a case–control study among a population of 160 PHIV adults with and without HTN who were receiving care at the University of Maryland and aged 18–35 years as of December 31, 2017. Covariates assessed included traditional risk factors such as age, family history of HTN, and smoking, as well as HIV- and antiretroviral-associated covariates. Results We identified 49 HTN cases (30.6%) and 111 (69.4%) controls. There were no significant differences in the odds of most traditional (age, gender, race, family history of HTN, tobacco, alcohol, and/or other drug use) or HIV-associated (CD4 nadir <100 cells/mm3, individual ART exposure, ART interruption) risk factors among PHIV adults with HTN compared with those with no diagnosis of HTN. Cases had lower odds of a history of treatment with lopinavir/ritonavir (LPV/r). Cases had 3.7 (95% CI 1.11, 12.56) times the odds of a prior diagnosis of chronic kidney disease (CKD) compared with controls after controlling for CD4 nadir and ARV treatment history. Conclusion The results of this study suggest that most traditional and HIV-related risk factors do not appear to increase the odds of having HTN in this PHIV cohort. However, HTN among PHIV may be driven in part by CKD, and a focus on the prevention and early management of CKD in this group may be necessary to prevent the development of HTN. Additionally, there may be as yet unidentified risk factors for HTN among PHIV which require further exploration. Given the large and growing population of PHIV entering adulthood worldwide, it is imperative to explore risk factors for and effects of HTN in large, diverse PHIV populations. Disclosures All authors: No reported disclosures.


2003 ◽  
Vol 6 (8) ◽  
pp. 743-749 ◽  
Author(s):  
Marilda B Neutzling ◽  
José August AC Taddei ◽  
Denise P Gigante

AbstractObjective:To study risk factors associated with overweight and obesity among adolescents enrolled in private high schools in the city of Pelotas, southern Brazil.Method:This was a case–control study. The subjects were 264 overweight (body mass index (BMI) ≥85th percentile of the National Center for Health Statistics (NCHS) reference population) and 264 non-overweight (BMI > 5th and <85th NCHS percentiles) adolescents identified by means of an anthropometric survey which included 1608 students. The adolescents were weighed, measured and interviewed about food habits and physical activity at school. Parents provided their own weights and heights when contacted by telephone, and parental BMI was calculated.Results:Hierarchical multiple conditional logistic regression showed that overweight and obesity were positively associated with mother's (odds ratio (OR) 2.86, 95% confidence interval (Cl) 1.43–5.74) and father's (OR 2.43, 95% Cl 1.37–4.30) BMI ≥ 30 kg m−2, being overweight before 10 years of age (OR 2.26, 95% Cl 1.30–3.90) and the habit of dieting (OR 3.53, 95% Cl 1.76–7.22). Having more than three meals per day was found to be a protective factor against overweight and obesity (OR 0.54, 95% Cl 0.29–1.00).Conclusion:The present study showed that a family history of obesity, overweight during childhood and the habit of dieting for weight-loss purposes are factors associated with obesity during adolescence. The habit of having more than three daily meals turned out to be a protective factor against overweight. These results suggest the necessity for early intervention at the family and general community levels aimed at the prevention of obesity through actions directed towards the modification of established behaviours.


2019 ◽  
Vol 110 (1) ◽  
pp. 212-220 ◽  
Author(s):  
Jingping Zhang ◽  
Jingjing Cao ◽  
Hao Zhang ◽  
Chongfei Jiang ◽  
Tengfei Lin ◽  
...  

ABSTRACT Background Previous studies indicated that trace elements may play an important role in cardiovascular diseases. However, data concerning the association between blood copper and the risk of stroke are limited. Objective The aim of this study was to evaluate the association between plasma copper and the risk of first stroke, and examine any possible effect modifiers in hypertensive patients. Methods We conducted a nested case-control study, using data from the China Stroke Primary Prevention Trial. Hypertension is defined as systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg, or taking antihypertensive medication. A total of 618 first stroke cases and 618 controls matched for age, sex, treatment group, and study site were included in this study. The crude and adjusted risks of first stroke were estimated by ORs and 95% CIs using conditional logistic regression, without or with adjusting for pertinent covariates, respectively. Results There were significant positive associations of plasma copper with risk of first stroke (per SD increment—OR: 1.20; 95% CI: 1.03, 1.39) and first ischemic stroke (OR: 1.26; 95% CI: 1.07, 1.50). When plasma copper was categorized in quartiles, significantly higher risks of first stroke (OR: 1.72; 95% CI: 1.12, 2.65) and first ischemic stroke (OR: 1.91; 95% CI: 1.18, 3.11) were found in participants in quartile 4 (≥ 117.0 μg/dL) than in those in quartile 1 (< 91.2 μg/dL). Furthermore, the plasma copper–first stroke association was significantly stronger in participants with higher BMI (< 25.0 compared with ≥ 25.0 kg/m2, P-interaction = 0.024). However, there was no significant association between plasma copper and first hemorrhagic stroke. Conclusions In Chinese hypertensive patients, there was a significant positive association between baseline plasma copper and the risk of first stroke, especially among those with higher BMI. This trial was registered at clinicaltrials.gov as NCT00794885.


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