Lung function as a modifiable risk factor for Ischemic Stroke: Evidence from the UK biobank

IF 1.8 4区 医学 Q3 NEUROSCIENCES
Zihong Bai , Qingcui Huang , Xinya Li , Yitong Ling , Panwen Wu , Xiaxuan Huang , Shanyuan Tan , Jun Lyu
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Abstract

Background

Ischemic stroke remains a leading cause of disability and mortality worldwide, with pulmonary function emerging as a potential modifiable risk factor.

Methods

This study utilizes data from the UK Biobank to explore the association between peak expiratory flow (PEF), a simple and cost-effective marker of lung function, and ischemic stroke risk. A total of 307,827 participants were followed for a median of 13.8 years, with Cox regression models employed to examine the relationship between PEF and ischemic stroke incidence. Restricted cubic splines and mediation analysis were also used to investigate potential nonlinear relationships and the mediating role of inflammatory biomarkers, respectively.

Results

The results demonstrate that individuals with higher PEF levels exhibit a significantly reduced risk of ischemic stroke, with a 6.7 % and 10.4 % lower risk in the second and third tertiles of PEF, respectively, compared to the first tertile.Stratified analyses revealed a significant inverse association between PEF and stroke risk in former smokers (HR = 0.93, 95 %CI:0.88–0.98), with a non-significant trend in current smokers (HR = 0.92, 95 %CI:0.84–1.01). Subgroup analysis revealed heterogeneity by age, gender, hypertension, and diabetes status, highlighting differential effects. Mediation analysis suggested that inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio, partially mediate the association between lung function and stroke risk.

Conclusion

This study underscores the importance of monitoring lung function, particularly at the community level, as a preventive measure against ischemic stroke. Given the aging global population, early detection and management of declining lung function could play a crucial role in reducing stroke-related morbidity and mortality.
肺功能作为缺血性中风的可改变危险因素:来自英国生物银行的证据。
背景:在世界范围内,缺血性脑卒中仍然是致残和死亡的主要原因,肺功能是一个潜在的可改变的危险因素。方法:本研究利用来自UK Biobank的数据,探讨呼气峰流量(PEF)与缺血性卒中风险之间的关系,PEF是一种简单而经济的肺功能指标。共有307,827名参与者被随访,中位时间为13.8年,采用Cox回归模型来检验PEF与缺血性脑卒中发病率之间的关系。限制三次样条和中介分析也分别用于研究潜在的非线性关系和炎症生物标志物的中介作用。结果:研究结果表明,PEF水平较高的个体发生缺血性卒中的风险显著降低,PEF水平第二和第三分位数的风险分别比第一分位数低6.7%和10.4%。分层分析显示,前吸烟者PEF与卒中风险呈显著负相关(HR=0.93, 95%CI:0.88-0.98),目前吸烟者PEF与卒中风险呈显著负相关(HR=0.92, 95%CI:0.84-1.01)。亚组分析揭示了年龄、性别、高血压和糖尿病状况的异质性,突出了差异效应。中介分析表明,炎症生物标志物,如中性粒细胞与淋巴细胞比例,部分介导了肺功能与卒中风险之间的关联。结论:本研究强调了监测肺功能的重要性,特别是在社区水平,作为预防缺血性卒中的措施。鉴于全球人口老龄化,早期发现和管理肺功能下降可能在降低卒中相关发病率和死亡率方面发挥关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.00
自引率
4.00%
发文量
583
审稿时长
62 days
期刊介绍: The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.
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