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Zhong WW, Yuan Y, Jin HY, Tang JM, Zhao Q, Piao LY. Research progress in stroke risk perception assessment tool. Technol Health Care 2024:THC231343. [PMID: 39093084 DOI: 10.3233/thc-231343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
BACKGROUND One of the main illnesses in the globe that causes impairment and death in people is stroke. In the globe today, it ranks as the second leading cause of death and the leading cause of death in China. OBJECTIVE This paper analyses into the critical role of risk perception in developing individual awareness of stroke risk and encouraging proactive preventive health behaviors, essential for effective primary stroke prevention strategies and reduced stroke incidence. It discusses the concept of risk perception, the content and dimensions of global stroke assessment tools, and their application status, aiming to provide insights for their development and intervention research. METHODS Risk perception encompasses subjective assessments of stroke likelihood and severity, influenced by personal experiences, knowledge of risk factors, beliefs about prevention effectiveness, and emotional responses. Global stroke assessment tools, like the Framingham Stroke Risk Score and CHA2DS2-VASc Score, evaluate stroke risk based on factors such as age, gender, blood pressure, and cholesterol levels. In order to improve risk perception and proactive health management and lower the burden of strokes, the paper assesses the advantages and disadvantages of these tools and makes recommendations for improving accessibility, customizing interventions, running educational campaigns, promoting multidisciplinary collaboration, and integrating technology. RESULTS By combining the research tools of stroke risk perception, it is found that the evaluation tools are mostly single-dimensional evaluation tools centered on the two dimensions of onset possibility and susceptibility. CONCLUSION Some scholars have developed multi-dimensional evaluation tools, but the evaluation population is relatively limited, and the evaluation system lacks comprehensiveness and systematization.
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Affiliation(s)
- Wei-Wei Zhong
- School of Nursing, Yanbian University, Yan Ji, Jilin, China
| | - Yue Yuan
- Oncology Department, Yanbian University Hospital, Yan Ji, Jilin, China
| | - Hong-Yan Jin
- School of Nursing, Yanbian University, Yan Ji, Jilin, China
| | - Ji-Ming Tang
- School of Nursing, Yanbian University, Yan Ji, Jilin, China
| | - Qian Zhao
- School of Nursing, Yanbian University, Yan Ji, Jilin, China
| | - Li-Yan Piao
- School of Nursing, Yanbian University, Yan Ji, Jilin, China
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Su J, Fan X, Li M, Yu H, Geng H, Qin Y, Lu Y, Pei P, Sun D, Yu C, Lv J, Tao R, Zhou J, Ma H, Wu M. Association of lifestyle with reduced stroke risk in 41 314 individuals with diabetes: Two prospective cohort studies in China. Diabetes Obes Metab 2024; 26:2869-2880. [PMID: 38685601 DOI: 10.1111/dom.15606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 05/02/2024]
Abstract
AIM To investigate the associations of individual and combined healthy lifestyle factors (HLS) with the risk of stroke in individuals with diabetes in China. METHODS This prospective analysis included 41 314 individuals with diabetes [15 191 from the Comprehensive Research on the Prevention and Control of the Diabetes (CRPCD) project and 26 123 from the China Kadoorie Biobank (CKB) study]. Associations of lifestyle factors, including cigarette smoking, alcohol consumption, physical activity, diet, body shape and sleep duration, with the risk of stroke, intracerebral haemorrhage (ICH) and ischaemic stroke (IS) were assessed using Cox proportional hazard models. RESULTS During median follow-up periods of 8.02 and 9.05 years, 2499 and 4578 cases of stroke, 2147 and 4024 of IS, and 160 and 728 of ICH were documented in individuals with diabetes in the CRPCD and CKB cohorts, respectively. In the CRPCD cohort, patients with ≥5 HLS had a 14% lower risk of stroke (hazard ratio (HR): 0.86, 95% confidence interval (CI): 0.75-0.98) than those with ≤2 HLS. In the CKB cohort, the adjusted HR (95% CI) for patients with ≥5 HLS were 0.74 (0.66-0.83) for stroke, 0.74 (0.66-0.83) for IS, and 0.57 (0.42-0.78) for ICH compared with those with ≤2 HLS. The pooled adjusted HR (95% CI) comparing patients with ≥5 HLS versus ≤2 HLS was 0.79 (0.69-0.92) for stroke, 0.80 (0.68-0.93) for IS, and 0.60 (0.46-0.78) for ICH. CONCLUSIONS Maintaining a healthy lifestyle was associated with a lower risk of stroke, IS and ICH among individuals with diabetes.
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Affiliation(s)
- Jian Su
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xikang Fan
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Mengyao Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hao Yu
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Houyue Geng
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yu Qin
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yan Lu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Dianjianyi Sun
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education (Peking University), Beijing, China
| | - Canqing Yu
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education (Peking University), Beijing, China
| | - Jun Lv
- Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Ministry of Education (Peking University), Beijing, China
| | - Ran Tao
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinyi Zhou
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ming Wu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Noncommunicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Du Y, Yang L, An Y, Song Y, Lu Y. Health-related quality of life and associated factors in elderly individuals with dyslipidemia in rural Northern China. Qual Life Res 2023; 32:3547-3555. [PMID: 37495839 DOI: 10.1007/s11136-023-03489-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE The purpose of the study was to investigate health-related quality of life (HRQOL) and its associated factors among elderly individuals with dyslipidemia in rural Northern China. METHODS A cross-sectional study was conducted on 457 elderly individuals. The EQ-5D-5L questionnaire was used to assess HRQOL. Sociodemographic, anthropometric, lifestyle and health information was collected using a structured and standardized questionnaire. The Tobit regression model and multiple linear regression analysis were used to assess factors associated with HRQOL parameters including utility index and visual analogue score (EQ-VAS). RESULTS The mean age of the participating individuals was 68.04 ± 5.98 years. The median utility index and EQ-VAS scores were 0.942 (P25-P75: 0.876-1.000) and 80 (P25-P75: 70-90), respectively. Pain/discomfort was the most frequently reported complaint among the five health dimensions (50.5%). Illiterate and primary education levels, unemployed, widowed, smoking, secondhand smoke exposure, with hypertension or DM, chronic disease core knowledge scores < 8, and daily sedentary time ≥ 6 h were associated with lower HRQOL. CONCLUSION Pain/discomfort dimension was the most affected problems. Education, occupation, marital status, smoking, secondhand smoke exposure, chronic disease core knowledge, comorbidities, and daily sedentary time were significantly associated with HRQOL in the present study.
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Affiliation(s)
- Yage Du
- School of Nursing, Peking University, Beijing, 100191, China
| | - Liuqing Yang
- Linyi Center for Disease Control and Prevention, Linyi, 276000, Shandong, China
| | - Yu An
- Department of Endocrinology, Beijing Chaoyang Hospital, Beijing, 100020, China
| | - Ying Song
- School of Nursing, Peking University, Beijing, 100191, China
| | - Yanhui Lu
- School of Nursing, Peking University, Beijing, 100191, China.
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Moghadam-Ahmadi A, Soltani N, Ayoobi F, Jamali Z, Sadeghi T, Jalali N, Vakilian A, Lotfi MA, Khalili P. Association between metabolic syndrome and stroke: a population based cohort study. BMC Endocr Disord 2023; 23:131. [PMID: 37280576 DOI: 10.1186/s12902-023-01383-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/30/2023] [Indexed: 06/08/2023] Open
Abstract
Both metabolic syndrome (MetS) and stroke are associated with increased risk of mortality. Here, we aimed to assess the prevalence of MetS among adults using three definitions (Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and IDF ethnic specific cut-off for Iranian criteria) and its association with stroke. We performed a cross-sectional study of a total of 9991 adult participants of Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN cohort study). The MetS prevalence was evaluated in participants according to the different criteria. Multivariate logistic regression analyses were conducted to assess the association between three definitions of MetS with stroke. We found that MetS was significantly associated with higher odds of stroke according to NCEP-ATP III (odds ratio (OR): 1.89, 95% confidence interval (CI) 1.30-2.74), international IDF (OR:1.66, 95% CI: 1.15-2.40) and Iranian IDF (OR:1.48, 95% CI: 1.04-2.09) after adjusted for variables confounders. Furthermore, after adjustment, in receiver operating characteristic (ROC) curve, the AUROC was 0.79 (95% CI = 0.75-0.82), 0.78(95% CI = 0.74-0.82) and 0.78(95% CI = 0.74-0.81) for presence of MetS according to NCEP-ATP III, international IDF and Iranian IDF, respectively. ROC analyses revealed that all of these three criteria for MetS are "moderately accurate" for the identification of increased stroke risk.In conclusion, our results showed that MetS was associated with increased odds of stroke. Our findings implicate the importance of early identification, treatment, and ultimately prevention of the metabolic syndrome.
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Affiliation(s)
- Amir Moghadam-Ahmadi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neuro-immunology Research Scholar, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA, US
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Narjes Soltani
- Physiology-Pharmacology Research Center, Rafsanjan University of Medical Science, Rafsanjan, Iran
| | - Fatemeh Ayoobi
- Occupational Safety and Health Research Center, NICICO, World Safety Organization and Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jamali
- Pistachio Safety Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Clinical Research Development Unit (CRDU), Niknafs Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Tabandeh Sadeghi
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Pediatric Nursing, School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nazanin Jalali
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Alireza Vakilian
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Neurology Department, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Amin Lotfi
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital (CRDU), Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of internal Medicine, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Department of Epidemiology, School of Public Health, Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Zhou Q, Zhao Y, Chen H, Sun H, Sun Y, Li J, Yu H, Zhao Q, Zhang Z. Influence of lifestyle on stroke risk among adults over 65 years in northern China: A propensity score matched study. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Madsen TE, Samaei M, Pikula A, Yu AYX, Carcel C, Millsaps E, Yalamanchili RS, Bencie N, Dula AN, Leppert M, Rundek T, Dreyer RP, Bushnell C. Sex Differences in Physical Activity and Incident Stroke: A Systematic Review. Clin Ther 2022; 44:586-611. [PMID: 35418311 PMCID: PMC9195871 DOI: 10.1016/j.clinthera.2022.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/03/2022] [Accepted: 02/12/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Physical inactivity, a modifiable risk factor for cardiovascular disease, is independently associated with stroke. Though some prior data have suggested sex differences in levels of physical activity, whether there are sex differences in the role of physical activity in primary stroke prevention is largely unknown. This systematic review identifies and describes recent findings on sex differences in the association between physical activity and incident (first-ever) stroke. This review also describes the current evidence on the strength of the association between physical activity and a reduced stroke risk in women in particular. METHODS Using a prespecified strategy, PubMed/MEDLINE and Cochrane Central were searched to identify observational studies or trials published from 2000 to 2020 and reporting sex differences in physical activity and incident stroke. To be included, among other criteria, studies had to include sex-specific effect estimates from women, men, or both. Titles, abstracts, and full-text articles were screened to identify studies meeting the inclusion criteria, and adjusted sex-specific estimates of the association between physical activity and incident stroke for total stroke (ischemic plus hemorrhagic) or ischemic stroke were abstracted. FINDINGS Thirty-seven studies met the inclusion criteria. Of 17 studies that included data on total incident stroke (ischemic and hemorrhagic combined) in both women and men, 7 (41%) showed similar associations between physical activity and incident stroke between women and men, 6 (35%) suggested a significant effect in women but not in men, and 3 (18%) showed a significant effect in men but not in women. Of 10 studies that included data on ischemic stroke in women and men, 5 (50%) suggested similar effects in women and men, 4 (40%) suggested a significant effect in women but not in men, and 1 (10%) showed an effect in men but not women. In women specifically, the majority of included studies demonstrated a reduced risk for incident stroke with physical activity, with relative risk reductions ranging from 11% to 72%, though most estimates fell between 20% and 40%. IMPLICATIONS The majority of studies indicated a clear association between physical activity and a reduction in stroke risk. Studies were split as to the potential for sex differences in this association. Future prospective investigations should identify strategies for the use of increased physical activity for primary stroke prevention, with sex-specific considerations as warranted. The data on sex-specific dose-response relationship between physical activity and stroke risk are inconclusive and warrant more research.
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Affiliation(s)
- Tracy E Madsen
- Department of Emergency Medicine, Warren Alpert Medical School, and the Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
| | - Mehrnoosh Samaei
- Department of Emergency Medicine, Division of Sex and Gender in Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Aleksandra Pikula
- Department of Medicine (Neurology), University of Toronto, University Health Networks, Toronto, Ontario, Canada
| | - Amy Y X Yu
- Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Nicole Bencie
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Adrienne N Dula
- Departments of Neurology and Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Texas
| | - Michelle Leppert
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Rachel P Dreyer
- Center for Outcomes Research and Evaluation, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Cheryl Bushnell
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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He C, Wang W, Chen Q, Shen Z, Pan E, Sun Z, Lou P, Zhang X. Factors associated with stroke among patients with type 2 diabetes mellitus in China: a propensity score matched study. Acta Diabetol 2021; 58:1513-1523. [PMID: 34125293 DOI: 10.1007/s00592-021-01758-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/05/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE This study aimed to examine the prevalence of stroke and associated factors of stroke in patients with type 2 diabetes(T2DM) in China. METHODS Participants were 18,013 T2DM patients recruited with stratified random cluster sampling method from December 2013 to January 2014 in China. Propensity score matching was used to eliminate confounding effects between groups and logistic regression analysis was used to examine factors associated with stroke among T2DM patients. RESULTS Overall, the prevalence of stroke in the subjects with T2DM was 9.5%. After nearest neighbor matching, smoking (OR = 1.60, 95%CI: 1.26-2.03), hypertension (OR = 2.96, 95%CI: 2.55-3.43), dyslipidemia (OR = 2.00, 95%CI: 1.71-2.33), family history of stroke (OR = 2.02, 95%CI: 1.61-2.54), obesity (OR = 1.21, 95%CI: 1.01-1.45) and sleep duration < 6 h/day (OR = 1.44, 95%CI: 1.20-1.73) or > 8 h/day (OR = 1.22, 95%CI: 1.05-1.42) were positively associated with stroke, whereas drinking 1-3 days/week (OR = 0.64, 95%CI: 0.45-0.90) or daily (OR = 0.45, 95%CI: 0.33-0.60), effective exercise (OR = 0.65, 95%CI: 0.57-0.73) and underweight (OR = 0.30, 95%CI: 0.13-0.71) were negatively related to stroke. Besides, the risk of stroke increased substantially with accumulation of above seven modified risk factors. The odds ratio values of stroke in patients having ≥ 5 of the above seven risk factors was 14.39 (95% CI: 8.87-23.26). CONCLUSIONS The prevalence of stroke was high among T2DM in China. It is of great significance to strengthen comprehensive management of health-related behaviors including smoking cessation, moderate alcohol consumption, effective exercise, 6-8 h of sleep duration, keeping normal weight and the prevention of hypertension and dyslipidemia to have sustained beneficial effects on improvements of stroke risk factors.
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Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Enchun Pan
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Zhongming Sun
- Huai´an Center for Disease Control and Prevention, Huai´an, 223001, Jiangsu, China
| | - Peian Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, 221000, Jiangsu, China
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
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Zhang N, Liang G, Liu M, Zheng G, Yu H, Shi Y, Zhang Y, Wang H, Li Y, Xu Y, Lu J. Metabolically healthy obesity increases the prevalence of stroke in adults aged 40 years or older: Result from the China National Stroke Screening survey. Prev Med 2021; 148:106551. [PMID: 33862034 DOI: 10.1016/j.ypmed.2021.106551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/16/2021] [Accepted: 04/11/2021] [Indexed: 12/29/2022]
Abstract
Debate over the cardio-cerebrovascular risk associated with metabolically healthy obesity (MHO) continues. In this study we investigated the association of MHO with the risk of stroke among 221,114 individuals aged 40 years or older based on data from the China National Stroke Screening and Prevention Project (CNSSPP), a nationally representative cross-sectional study, during 2014 to 2015. Different metabolic health and obesity phenotypes were defined according to the Adult Treatment Panel III (ATP III) criteria, where obesity was defined as a body mass index (BMI) ≥28 kg/m2. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for stroke risk associated with different metabolically healthy phenotypes. BMI was used to estimate the mediation effect for metabolic abnormalities to stroke. Compared with the metabolically healthy non-obesity (MHNO) group, individuals with MHO (adjusted OR: 1.21, 95% CI: 1.10,1.33), metabolically unhealthy non-obesity (MUNO) (adjusted OR:1.41, 95% CI: 1.36,1.46), or metabolically unhealthy obesity (MUO) (adjusted OR: 1.70, 95% CI: 1.61,1.80) were found to have an increased risk of stroke. The findings were confirmed robustly by various sensitivity analyses and subgroup analyses. Furthermore, obesity and metabolic abnormalities had an additive interaction for stroke risk with an attributable proportion (AP) of 14.0% in females. BMI played a partial mediating role with the proportion of the effect (PE) at 11.1% in the relationship between metabolic abnormalities and stroke. This study strengthens the evidence that management and interventions in the MHO population may contribute to the primary prevention of stroke.
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Affiliation(s)
- Ningning Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Ge Liang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Mengying Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Guowei Zheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hailan Yu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yage Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yihe Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yapeng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Jie Lu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.
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Influences of Daily Life Habits on Risk Factors of Stroke Based on Decision Tree and Correlation Matrix. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2020; 2020:3217356. [PMID: 32565878 PMCID: PMC7285386 DOI: 10.1155/2020/3217356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/29/2020] [Indexed: 12/14/2022]
Abstract
Purpose To explore the influences of smoking, alcohol consumption, drinking tea, diet, sleep, and exercise on the risk of stroke and relationships among the factors, present corresponding knowledge-based rules, and provide a scientific basis for assessment and intervention of risk factors of stroke. Methods The decision tree C4.5 algorithm was optimized and utilized to establish a model for stroke risk assessment; then, the main risk factors of stroke (including hypertension, dyslipidemia, diabetes, atrial fibrillation, body mass index (BMI), history of stroke, family history of stroke, and transient ischemic attack (TIA)) and daily habits (e.g., smoking, alcohol consumption, drinking tea, diet, sleep, and exercise) were analyzed; corresponding knowledge-based rules were finally presented. Establish a correlation matrix of stroke risk factors and analyze the relationship between stroke risk factors. Results The accuracy of the established model for stroke risk assessment was 87.53%, and the kappa coefficient was 0.8344, which was superior to that of the random forest and Logistic algorithm. Additionally, 37 knowledge-based rules that can be used for prevention of risk factors of stroke were derived and verified. According to in-depth analysis of risk factors of stroke, the values of smoking, exercise, sleep, drinking tea, alcohol consumption, and diet were 6.00, 7.00, 8.67, 9.33, 10.00, 10.60, and 10.75, respectively, indicating that their influence on risk factors of stroke was reduced in turn; on the one hand, smoking and exercise were strongly associated with other risk factors of stroke; on the other hand, sleep, drinking tea, alcohol consumption, and diet were not firmly associated with other risk factors of stroke, and they were relatively tightly associated with smoking and exercise. Conclusions Establishment of a model for stroke risk assessment, analysis of factors influencing risk factors of stroke, analysis of relationships among those factors, and derivation of knowledge-based rules are helpful for prevention and treatment of stroke.
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