Carotid Intima-Media Thickness, Genetic Risk, and Ischemic Stroke: A Family-Based Study in Rural China

[A ssociations of short-term ambient particulate matter exposure and MTNR1B gene with triglyceride-glucose index: A family-based study]

OBJECTIVE

To explore the effects of short-term particulate matter (PM) exposure and the melatonin receptor 1B (MTNR1B) gene on triglyceride-glucose (TyG) index utilizing data from Fang-shan Family-based Ischemic Stroke Study in China (FISSIC).

METHODS

Probands and their relatives from 9 rural areas in Fangshan District, Beijing, were included in the study. PM data were obtained from fixed monitoring stations of the National Air Pollution Monitoring System. TyG index was calculated by fasting triglyceride and glucose concentrations. The associations of short-term PM exposure and rs10830963 polymorphism of the MTNR1B gene with the TyG index were assessed using mixed linear models, in which covariates such as age, sex, and lifestyles were adjusted for. Gene-environment inter-action analysis was furtherly performed using the maximum likelihood methods to explore the potential effect modifier role of rs10830963 polymorphism in the association of PM with TyG index.

RESULTS

A total of 4 395 participants from 2 084 families were included in the study, and the mean age of the study participants was (58.98±8.68) years, with 53. 90% females. The results of association analyses showed that for every 10 μg/m3 increase in PM2.5 concentration, TyG index increased by 0.017 (95%CI: 0.007-0.027), while for per 10 μg/m3 increment in PM10, TyG index increased by 0.010 (95%CI: 0.003-0.017). And the associations all had lagged effects. In addition, there was a positive association between the rs10830963 polymorphism and the TyG index. For per increase in risk allele G, TyG index was elevated by 0.040 (95%CI: 0.004-0.076). The TyG index was 0.079 (95%CI: 0.005-0.152) higher in carriers of the GG genotype compared with carriers of the CC genotype. The interaction of rs10830963 polymorphism with PM exposure had not been found to be statistically significant in the present study.

CONCLUSION

Short-term exposure to PM2.5 and PM10 were associated with higher TyG index. The G allele of rs10830963 polymorphism in the MTNR1B gene was associated with the elevated TyG index.

Association of Lipoprotein-associated phospholipase A2 With Carotid Intima-Media Thickness in Acute Cerebral Infarction Patients

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory marker associated with atherosclerotic and cardiovascular diseases. This study aimed to explore the association of Lp-PLA2 with carotid intima-media thickness (cIMT) in patients with acute ischemic stroke (AIS) and explore a threshold level to predict the risk of vulnerable plaques. This retrospective observational study included patients with AIS in the Neurology Department of our Hospital between January 2018 and December 2019. The study included 293 patients aged 65.29 ± 12.11 years, including 212 males, of whom 124 had carotid intima-media thickening (42.32%). Multivariable logistic regression showed that Lp-PLA2 level was an independent risk factor for cIMT (odds ratio [OR] = 1.004, 95% confidence interval [95% CI] 1.001-1.008, P = .008). Threshold effect analysis showed that the risk of vulnerable carotid plaque occurrence increased by 2% for every 1 ng/mL increase in Lp-PLA2 level with serum Lp-PLA2 levels between 157 and 279 ng/mL; this increase was statistically significant (OR = 1.02, 95% CI 1.01-1.03, P < .001). Serum Lp-PLA2 is an independent risk factor for increased cIMT in patients with AIS, and a threshold Lp-PLA2 level between 157 and 279 ng/mL showed a higher risk of carotid plaque rupture.

Association between polymorphisms in miRNAs and ischemic stroke: A meta-analysis

BACKGROUND

Atherosclerosis remains a predominant cause of ischemic stroke (IS). Four miRNA polymorphisms associated with arteriosclerosis mechanism were meta-analyzed to explore whether they had predictive significance for IS.

METHODS

PubMed, Excerpta Medica database, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure, and China Wanfang Database were searched for relevant case-control studies published before September 2022. Two researchers independently reviewed the studies and extracted the data. Data synthesis was carried out on eligible studies. Meta-analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were performed using Stata software 16.0.

RESULTS

Twenty-two studies were included, comprising 8879 cases and 12,091 controls. The results indicated that there were no significant associations between miR-146a C>G (rs2910164), miR-196a2 T>C (rs11614913) and IS risk in the overall analyses, but miR-149 T>C (rs2292832) and miR-499 A>G (rs3746444) increased IS risk under the allelic model, homozygote model and recessive model. The subgroup analyses based on Trial of Org 101072 in Acute Stroke Treatment classification indicated that rs2910164 increased small artery occlusion (SAO) risk under the allelic model, heterozygote model and dominant model; rs11614913 decreased the risk of SAO under the allelic model, homozygote model, heterozygote model and dominant model.

CONCLUSION

This Meta-analysis showed that all 4 single nucleotide polymorphisms were associated with the risk of IS or SAO, even though the overall and subgroup analyses were not entirely consistent.

Association between hemoglobin A1c and asymptomatic carotid intima-media thickness in middle-aged and elderly populations without diabetes

BACKGROUND AND AIMS

Carotid atherosclerosis, including carotid artery intima-media thickness, plaques, and stenosis, is an important risk factor for stroke. However, the association between hemoglobin A_1c (HbA_1c) and carotid intima-media thickness (cIMT) was inconsistent. The aim of this study was to explore the association between HbA_1c and the risk of increased cIMT among the Chinese population aged ≥40 years without diabetes.

METHODS AND RESULTS

A total of 3528 participants without diabetes from the China National Stroke Screen Survey program were enrolled in this study. cIMT was measured using duplex ultrasound examination. Logistic regression models were used to assess the association between HbA_1c level and the risk of increased cIMT. A total of 565 (16.0%) participants had increased cIMT. After adjustment for other potential confounding factors, higher levels of HbA_1c increased the risk of increased cIMT compared with the lowest level, and the odds ratios for quartile 2, quartile 3, and quartile 4 were 1.58, 1.67, and 1.98, respectively. Age had an interaction impact on the association between HbA_1c level and the risk of increased cIMT.

CONCLUSION

In this large-scale and cross-sectional study, high-normal HbA_1c was associated with the risk of increased asymptomatic cIMT in a rural Chinese population without diabetes, especially in individuals aged <60 years.