Chronic Hepatitis B Virus Infection and Risk of Stroke Types: A Prospective Cohort Study of 500â
000 Chinese Adults.
Stroke
; 54(12): 3046-3053, 2023 12.
Article
em En
| MEDLINE
| ID: mdl-37942646
ABSTRACT
BACKGROUND:
Stroke is a leading cause of mortality and permanent disability in China, with large and unexplained geographic variations in rates of different stroke types. Chronic hepatitis B virus infection is prevalent among Chinese adults and may play a role in stroke cause.METHODS:
The prospective China Kadoorie Biobank included >500â 000 adults aged 30 to 79 years who were recruited from 10 (5 urban and 5 rural) geographically diverse areas of China from 2004 to 2008, with determination of hepatitis B surface antigen (HBsAg) positivity at baseline. During 11 years of follow-up, a total of 59â 117 incident stroke cases occurred, including 11â 318 intracerebral hemorrhage (ICH), 49â 971 ischemic stroke, 995 subarachnoid hemorrhage, and 3036 other/unspecified stroke. Cox regression models were used to estimate adjusted hazard ratios (HRs) for risk of stroke types associated with HBsAg positivity. In a subset of 17â 833 participants, liver enzymes and lipids levels were measured and compared by HBsAg status.RESULTS:
Overall, 3.0% of participants were positive for HBsAg. HBsAg positivity was associated with an increased risk of ICH (adjusted HR, 1.29 [95% CI, 1.16-1.44]), similarly for fatal (n=5982; adjusted HR, 1.36 [95% CI, 1.16-1.59]) and nonfatal (n=5336; adjusted HR, 1.23 [95% CI, 1.06-1.44]) ICH. There were no significant associations of HBsAg positivity with risks of ischemic stroke (adjusted HR, 0.97 [95% CI, 0.92-1.03]), subarachnoid hemorrhage (adjusted HR, 0.87 [95% CI, 0.57-1.33]), or other/unspecified stroke (adjusted HR, 1.12 [95% CI, 0.89-1.42]). Compared with HBsAg-negative counterparts, HBsAg-positive individuals had lower lipid and albumin levels and higher liver enzyme levels. After adjustment for liver enzymes and albumin, the association with ICH from HBsAg positivity attenuated to 1.15 (0.90-1.48), suggesting possible mediation by abnormal liver function.CONCLUSIONS:
Among Chinese adults, chronic hepatitis B virus infection is associated with an increased risk of ICH but not other stroke types, which may be mediated through liver dysfunction and altered lipid metabolism.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
Problema de saúde:
2_muertes_prematuras_enfermedades_notrasmisibles
Assunto principal:
Hemorragia Cerebral
/
Hepatite B Crônica
/
Acidente Vascular Cerebral Hemorrágico
Limite:
Adult
/
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Stroke
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Reino Unido