Hypertriglyceridemic waist phenotype: Association with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke.

Objective: To explore the relationship of hypertriglyceridemic waist phenotype (HTWP) with initial neurological severity and etiologic subtypes in patients with acute ischemic stroke. Methods: The data for this study were collected from hospitalized patients within 72 h of acute ischemic stroke onset at the Department of Neurology of the Affiliated Hospital of Beihua University from 1 July 2020 to 30 June 2022. The initial neurological severity was assessed by the National Institute of Health Stroke Scale (NIHSS) on the day of admission: NIHSS <6 was defined as mild stroke, and NIHSS ≥6 as moderate to severe stroke. HTWP was defined by fasting serum triglycerides ≥1.7 mmol/L and waist circumference ≥90 cm in men and ≥80 cm in women. Differentiation of etiologic subtypes was based on the method reported in the Trial of Org 10 172 in Acute Stroke Treatment. Multivariate logistic regression analysis was used to analyze the association of HTWP with initial neurological severity and etiologic subtypes. Results: The study included 431 patients. Compared with the normal waist-normal blood triglyceride group, patients with HTWP had reduced risks of moderate to severe stroke [odds ratio (OR): 0.384, 95% confidence interval (CI): 0.170-0.869; P = 0.022]. In addition, the risk of small-artery occlusion stroke was 2.318 times higher in the HTWP group than in the normal triglyceride-normal waist (NWNT) group (OR: 2.318, 95% CI: 1.244-4.319; P = 0.008). Conclusion: Initial neurological severity was less severe in patients with HTWP, and HTWP was associated with an increased risk of small-artery occlusion stroke.

Impact of Stroke Severity on the Smoking Paradox in Patients Treated with Intravenous Thrombolysis.

OBJECTIVE: To our knowledge, no previous studies have investigated the impact of stroke severity on the smoking paradox after intravenous thrombolysis (IVT). We aimed to explore the contribution of stroke severity to the association between smoking and stroke prognosis after IVT. METHODS: We enrolled consecutive patients who received IVT within 4.5 hours from stroke onset. A logistic regression model was used to estimate the unadjusted and adjusted odds ratios (ORs) with their 95% confidence intervals (CIs) for poor functional outcome and mortality at 3 months. RESULTS: Among patients with moderate stroke, smokers experienced a lower risk of 3-month poor outcomes than non-smokers (33.0% vs. 44.4%, unadjusted OR: 0.616; 95% CI: 0.402-0.945). However, among those with severe stroke, smokers had a higher risk of 3-month poor outcomes than non-smokers (81.6% vs. 55.9%, unadjusted OR: 3.496; 95% CI: 1.207-10.127). After adjustment, the negative correlation between smoking and 3-month poor outcome following IVT lost statistical significance in patients with moderate stroke (OR: 0.677 [95% CI: 0.418-1.097]). However, smoking remained a risk factor for 3-month poor outcomes in patients with severe stroke (OR: 4.216 [95% CI: 1.236-14.385]). We also observed a significant interaction between smoking and stroke severity with regard to the risk of poor functional outcomes (p=0.023). However, no such interaction influenced mortality (p=0.901). CONCLUSION: Stroke severity affects the association between smoking and 3-month clinical functional outcomes following IVT.

Association Between Cardiometabolic Index and Stroke: A Population- based Cross-sectional Study.

BACKGROUND: Cardiometabolic Index (CMI) was associated with several risk factors for stroke; however, few studies assessed the role of CMI in stroke risk. OBJECTIVE: This study aimed to assess the association between CMI and stroke in a population- based cross-sectional study. METHODS: This study included 4445 general residents aged ≥40 years selected by multistage stratified random cluster sampling. CMI was calculated as the product of the ratio of waist circumference to height (WHtR) and the ratio of triglyceride levels to high-density lipoprotein cholesterol levels (TG/HDL-C). Participants were categorized according to CMI quartiles: quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curves were used to assess the association between CMI and stroke. RESULTS: A total of 4052 participants were included in the study, with an overall stroke prevalence of 7.2%. The prevalence of stroke increased with CMI quartiles, ranging from 4.4% to 9.2% (p for trend <0.001). Compared with Q1, stroke risk for Q2, Q3, and Q4 were 1.550-, 1.693-, and 1.704- fold, respectively. The area under the ROC curve (AUC) (95% CI) was 0.574 (0.558-0.589) for CMI, 0.627 (0.612-0.642) for WHtR, 0.556 (0.540-0.571) for TG/HDL-C. CMI was inferior to WHtR (p=0.0024), but CMI had a marginal advantage over TG/HDL-C (p<0.0001) in terms of its stroke discrimination ability. CONCLUSION: Although there was a strong and independent association between CMI and stroke in the general population, CMI had limited discriminating ability for stroke. Thus, new parameters should be developed.

Strong Association of Waist Circumference (WC), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist-to-Hip Ratio (WHR) with Diabetes: A Population-Based Cross-Sectional Study in Jilin Province, China.

BACKGROUNDS: The prevalence of diabetes has increased with the increase of obesity, and finding indicators to predict diabetes risk has become an urgent need. The purpose of this study is to compare the correlation between four anthropometric indices and the prevalence of diabetes. METHODS: A total of 4052 participants aged 40 years and above were selected in Dehui City, Jilin Province, using a multistage stratified whole group sampling method. Face-to-face interviews and physical examinations were conducted. Multivariate logistic analysis was used. The values of BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were divided into quartiles (Q1: <25%; Q2: ~25%; Q3: ~50%; and Q4: ~75%). The median of each quartile was used for a linear trend test. RESULTS: For all four body fat-measuring indices of body mass index (adjusted OR: 3.300, 95% CI: 2.370, 4.595), WC (adjusted OR: 5.131, 95% CI: 3.433, 7.669), WHR (adjusted OR: 3.327, 95% CI: 2.386, 4.638), and WHtR (adjusted OR: 5.959, 95% CI: 3.922, 9.054), patients in the highest quartile were more likely to have diabetes than those in the lowest quartile. The areas under the curve of WHtR, WC, WHR, and BMI for diabetes were 0.683, 0.669, 0.654, and 0.629, respectively. In female participants, the areas under the curve of the waist-height ratio and WC were 0.710 (95% CI: 0.679-0.741) and 0.701 (95% CI: 0.670-0.732), respectively. CONCLUSIONS: The WC and WHtR were more closely related to diabetes than BMI and WHR among study participants ≥ 40 years of age, especially in females.

Sex-based differences in and risk factors for metabolic syndrome in adults aged 40 years and above in Northeast China: Results from the cross-sectional China national stroke screening survey.

OBJECTIVES: Low levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This study aimed to determine sex-based differences associated with the prevalence of and risk factors for metabolic syndrome among people older than 40 years in Northeast China; this has not been previously investigated. DESIGN: This study analysed a portion of the large sample data of the national cross-sectional screening of China from 2016. Metabolic syndrome was defined as the presence of any three of the following five risk factors: abnormal waist circumference; high levels of triglycerides, high-density lipoprotein cholesterol or fasting plasma glucose; and elevated blood pressure. Multiple regression analysis was used to investigate sex-based differences in the prevalence of, and risk factors for metabolic syndrome. SETTING: The study was conducted in Dehui City, Jilin Province, China. PARTICIPANTS: A total of 4052 participants with complete questionnaire information and laboratory examination results were included. RESULTS: The prevalence of metabolic syndrome was 50.1% overall (38.4% in men and 57.9% in women; p<0.001). High body mass index and hip circumference were associated with metabolic syndrome in both sexes. In addition, physical inactivity (OR and 95% CI 1.44 (1.06 to 1.97); p=0.022) in men and advanced age (OR and 95% CI 1.54 (1.15 to 2.04); p=0.003) in women were factors associated with metabolic syndrome. Women with junior high school education or above and living in rural areas were less likely to have metabolic syndrome. For men, education and rural or urban living had no association with metabolic syndrome. CONCLUSIONS: The risk factors for metabolic syndrome have similarities and differences in different sexes; thus, the prevention and treatment of metabolic syndrome should be based on these sex differences.

Intracranial Calcification is Predictive for Hemorrhagic Transformation and Prognosis After Intravenous Thrombolysis in Non-Cardioembolic Stroke Patients.

AIM: Hemorrhagic transformation is the major complication of intravenous thrombolysis. Calcification is used widely as an imaging indicator of atherosclerotic burden and cerebrovascular function. The relationship between intracranial calcification and hemorrhagic transformation has not been explored fully. We aimed to identify and quantify calcification in the main cerebral vessels to investigate the correlations between quantitative calcification parameters, hemorrhagic transformation, and prognosis. METHODS: Acute, non-cardiogenic, ischemic stroke patients with anterior circulation who received intravenous thrombolysis therapy in the First Hospital of Jilin University were retrospectively and consecutively included. All included patients underwent a baseline CT before intravenous thrombolysis and a follow-up CT at 24 hours. A third-party software, ITK-SNAP, was used to segment and measure the calcification volume. A vascular non-bone component with a CT value ＞130 HU was considered calcified. Hemorrhagic transformation was determined based on the ECASS II classification criteria. RESULTS: The study included 242 patients, 214 of whom were identified as having calcification. Thirty-one patients developed hemorrhagic transformation. The calcification volume on the lesion side (0.1ml) was associated with hemorrhagic transformation (p=0.004, OR=1.504, 95% CI: 1.140-1.985). Ninety-six patients had poor prognoses. The poor prognosis group had more calcified vessels than the good prognosis group (p=0.014, OR=1.477, 95% CI: 1.083-2.015). CONCLUSIONS: The arterial calcification volume on the lesion side is associated with hemorrhagic transformation after thrombolysis. The higher the number of calcified vessels, the greater the risk of poor prognosis.

Association of Admission Leukocyte Count with Clinical Outcomes in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator.

OBJECTIVE: An increased leukocyte count is positively associated with poor outcomes and all-cause mortality in coronary heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important. We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients. METHODS: This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of symptom onset between January 2016 to December 2018. We assessed outcomes, including short-term hemorrhagic transformation (HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0-2 or 0-1). RESULTS: Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and 211 (36.4%) exhibited functional independence (mRS score: 0-2). Multivariable logistic regression revealed admission leukocyte count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3-6, odds ratio [OR]: 1.076, 95% confidence interval [CI]: 1.003-1.154, p=0.041) and 7.8% (mRS score: 2-6, OR: 1.078, 95% CI: 1.006-1.154, p=0.033). Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and lymphocyte count were not associated with 3-- month functional outcomes or 3-month mortality. CONCLUSION: A lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients undergoing rt-PA treatment.

Clinical Potential of Extracellular Vesicles in Type 2 Diabetes.

Type 2 diabetes (T2D) is a major public health disease which is increased in incidence and prevalence throughout the whole world. Insulin resistance (IR) in peripheral tissues and insufficient pancreatic ß-cell mass and function have been recognized as primary mechanisms in the pathogenesis of T2D, while recently, systemic chronic inflammation resulting from obesity and a sedentary lifestyle has also gained considerable attention in T2D progression. Nowadays, accumulating evidence has revealed extracellular vesicles (EVs) as critical mediators promoting the pathogenesis of T2D. They can also be used in the diagnosis and treatment of T2D and its complications. In this review, we briefly introduce the basic concepts of EVs and their potential roles in the pathogenesis of T2D. Then, we discuss their diagnostic and therapeutic potentials in T2D and its complications, hoping to open new prospects for the management of T2D.

Early prediction of the 3-month outcome for individual acute ischemic stroke patients who received intravenous thrombolysis using the N2H3 nomogram model.

BACKGROUND: The aim of this study was to establish a nomogram model for individualized early prediction of the 3-month prognosis in patients with acute ischemic stroke (AIS) who were treated with intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis. METHODS: A total of 691 patients were included in this study; 564 patients were included in the training cohort, while 127 patients were included in the test cohort. The main outcome measure was a 3-month unfavorable outcome (modified Rankin Scale 3-6). To construct the nomogram model, stepwise logistic regression analysis was applied to select the significant predictors of the outcome. The discriminative performance of the model was assessed by calculating the area under the receiver operating characteristic curve (AUC-ROC). A decision curve analysis was used to evaluate prognostic value of the model. RESULTS: The initial National Institutes of Health Stroke Scale [NIHSS, odds ratio (OR), 1.35; 95% confidence interval (CI), 1.28-1.44; p < 0.001], delta NIHSS (changes in the NIHSS score from baseline to 24 h, OR, 0.75; 95% CI, 0.70-0.79; p < 0.001), hypertension (OR, 2.07; 95% CI, 1.32-3.31; p = 0.002), hyperhomocysteinemia (Hhcy, OR, 2.18; 95% CI, 1.20-4.11; p = 0.013), and the ratio of high-density lipoprotein cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) (HDL-C/LDL-C, OR, 3.29; 95% CI, 1.00-10.89; p = 0.049) (N2H3) were found to be independent predictors of a 3-month unfavorable outcome from multivariate logistic regression analysis and were incorporated in the N2H3 nomogram model. The AUC-ROC of the training cohort was 0.872 (95% CI, 0.841-0.902), and the AUC-ROC of the test cohort was 0.900 (95% CI, 0.848-0.953). CONCLUSION: The study presented the N2H3 nomogram model, with initial NIHSS score, delta NIHSS, hypertension, Hhcy, and HDL-C/LDL-C as predictors. It therefore provides an individualized early prediction of the 3-month unfavorable outcome in AIS patients treated with intravenous rt-PA thrombolysis.

Primary Angiitis of the Central Nervous System Mimicking Glioblastoma: A Case Report and Literature Review.

Primary angiitis of the central nervous system (PACNS) is a rare disorder resulting in idiopathic inflammation affecting the parenchymal and leptomeningeal vessels confined to the central nervous system (CNS), of which a tumor-like mass lesion is an even rare subtype. We described a case of PACNS initially misdiagnosed as glioblastoma. The patient was a 35 year-old female with right-sided weakness and expressive dysphasia. Brain MRI showed a tumor-like lesion highly suggestive of glioblastoma, therefor surgical removal was done. After a resection and an exhaustive workup, PACNS was ultimately diagnosed. The case illustrates a type of imaging presentation of PACNS that is often misdiagnosed as high-grade glioma. Differentiation between tumor-like PACNS lesions and actual CNS tumors is challenging due to similar MR images. To avoid unnecessary surgical interventions, we summarized previously reported mass-forming PACNS cases in adults from January 1, 2000, to December 31, 2018 and the imaging characteristics of PACNS. Some less commonly used diagnostic methods such as MR spectroscopy may also help clinicians distinguish PACNS from its mimics.

Changes in cerebral autoregulation and blood biomarkers after remote ischemic preconditioning.

OBJECTIVE: To determine the effect of remote ischemic preconditioning (RIPC) on dynamic cerebral autoregulation (dCA) and various blood biomarkers in healthy adults. METHODS: A self-controlled interventional study was conducted. Serial measurements of dCA were performed at 7 time points (7, 9, and 11 am; 2, 5, and 8 pm, and 8 am on the next day) without or with RIPC, carried out at 7:20 to 8 am. Venous blood samples were collected at baseline (7 am) and 1 hour after RIPC, and blood biomarkers, including 5 neuroprotective factors and 25 inflammation-related biomarkers, were measured with a quantitative protein chip. RESULTS: Fifty participants were enrolled (age 34.54 ± 12.01 years, 22 men). Compared with the results on the day without RIPC, dCA was significantly increased at 6 hours after RIPC, and the increase was sustained for at least 24 hours. After RIPC, 2 neuroprotective factors (glial cell-derived neurotrophic factor and vascular endothelial growth factor-A) and 4 inflammation-related biomarkers (transforming growth factor-ß1, leukemia inhibitory factor, matrix metallopeptidase-9, and tissue inhibitor of metalloproteinase-1) were significantly elevated compared with their baseline levels. Conversely, monocyte chemoattractant protein-1 was significantly lower compared with its baseline level. CONCLUSIONS: RIPC induces a sustained increase of dCA from 6 to at least 24 hours after treatment in healthy adults. In addition, several neuroprotective and inflammation-related blood biomarkers were differentially regulated shortly after RIPC. The increased dCA and altered blood biomarkers may collectively contribute to the beneficial effects of RIPC on cerebrovascular function. CLINICALTRIALSGOV IDENTIFIER: NCT02965547.

Eagle Syndrome as a Cause of Cerebral Venous Sinus Thrombosis.

A 15-year-old teenager presented with a 2-month history of headache. Neurological examination was normal except for papilledema. Further lumbar puncture indicated intracranial hypertension (330 mm H2O). Brain magnetic resonance imaging (MRI) was normal but phase contrast-magnetic resonance venography (PC-MRV) (Figure 1(A)) suggested possible left transverse-sigmoid sinus thrombosis; subsequent contrast-enhanced 3D fat-saturated T1 volumetric isotropic turbo spin echo acquisition (VISTA) MRI (Figure 1(B)) confirmed the pathology. Hyper-coagulable panel results (including six steroid sex hormones, antithrombin III, protein C, protein S, lupus anticoagulant, and anticardiolipin antibodies) were all within normal range. In further examination, computed tomography (CT) venography images (Figure 1(C) and (D)) showed that the left jugular vein was compressed by the styloid process, consistent with Eagle syndrome.1 The patient who refused the recommended surgical treatment, however, chose anticoagulant therapy consisting of low-molecular weight heparin subcutaneous injection in addition to new oral anticoagulant. At 18-month follow-up, the patient reported no symptoms remained.

Study on the Clinical, Imaging, and Pathological Characteristics of 18 Cases with Primary Central Nervous System Vasculitis.

BACKGROUND: To summarize the characteristics of primary central nervous system vasculitis from clinical, imaging, and pathological aspects by retrospective study. METHODS: From March 2015 to December 2017, the data of the inpatients of primary central nervous system vasculitis in first Hospital of Jilin University were collected, and their clinical manifestation, imaging, and pathological characteristics were analyzed by using a descriptive method. RESULTS: There were 18 patients, 10 males (55.56%) and 8 females (44.44%) separately. The age ranges from 16 years old to 49 years old, with the median age of 32 years old. There were 8 cases (44.44%) of epileptic seizure, 6 cases (33.33%) of abnormal behavior and cognition, 10 cases (55.56%) with sensorimotor abnormalities, 4 cases (22.22%) with dizziness, 4 cases (22.22%) with headache, 2 cases (11.11%) with facial pain, 2 cases (11.11%) with blurred vision, and 2 cases (11.11%) with unstable walking. Eight patients (44.44%) were identified with cerebral spinal fluid abnormalities. There were 12 cases (66.67%) with bilateral lesions and 6 cases (33.33%) with unilateral lesions, including the frontal lobe (18 cases, 100%), the parietal lobe (10 cases, 55.56%), the temporal and occipital lobe (8 cases, 44.44%). There were 12 cases (66.67%) combined with subcortical white matter involvement, 6 cases (33.33%) combined with meningeal involvement, 2 cases (11.11%) complicated with basal ganglia involvement and 2 cases (11.11%) complicated with spinal cord involvement. Most of the lesions were with unclear border (16 cases, 88.89%), 2 cases (11.11%) were with clear border. Cortical atrophy was identified in 6 cases (33.33%). There were 12 cases (66.67%) with the enhancement of the lesions and meningeal. The 3D Vessel Wall magnetic resonance imaging (VW-MRI) showed uniform thickness in all patients (18/18) with contrast enhancement of the vessel wall of the vasculitis artery. CONCLUSIONS: The clinical manifestation and imaging in primary central nervous system vasculitis are diverse. The 3D VW-MRI could achieve quantification assessment of vasculitis and provide more utility for primary angiitis of the central nervous system.

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China.

Background: Stroke is a leading cause of long-term adult disability and death in China, and primary prevention is essential for stroke. The aim of this study is to compare the four anthropometric indexes (body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio) and identify the index that is most closely related to stroke in areas with high incidence of stroke. Methods: A total of 4,052 participants aged 40 years or older were selected by the multistage stratified cluster sampling method in Dehui City in Jilin province, China. Face-to-face interviews and physical examinations were conducted to collect the participants' information. Descriptive data analyses were conducted. Multivariable logistic analyses were used to explore the adjusted association between stroke and body fat measuring indexes. Results: For body mass index (adjusted odds ratio (OR): 1.13, 95% confident interval (CI): 0.77-1.65), waist circumference (adjusted OR: 1.32, 95% CI: 0.88-1.99), and waist-to-hip ratio (adjusted OR: 1.34, 95% CI: 0.92-1.93), the patients in the highest quartile did not have a higher risk of stroke than those in the lowest quartile. For waist-to-height ratio, the patients in the highest quartile were more likely have a stroke than those in the lowest quartile (adjusted OR: 1.81, 95% CI: 1.16-2.82). The area under the curve of waist-to-height ratio, waist-to-hip ratio, waist circumference, and body mass index for stroke were 0.627 (95% CI: 0.595-0.659; sensitivity: 65.10%; specificity: 56.00%), 0.596 (95% CI: 0.593-0.629; sensitivity: 69.90%, specificity: 45.90%), 0.612 (95% CI: 0.579-0.644; sensitivity: 52.70%, specificity: 64.70%), and 0.548 (95% CI: 0.514-0.583; sensitivity: 57.90%, specificity: 51.10%), respectively. Conclusions: The waist-to-height ratio was more closely related to the prevalence of stroke than body mass index, waist circumference, and weight-to-hip ratio among the study participants aged ≥ 40 years.

Association Between Obesity Type and Common Vascular and Metabolic Diseases: A Cross-Sectional Study.

Background: The association between different types of obesity and some chronic diseases in Dehui, Jilin province, China, is still unclear. The aim of our study was to clarify the association between different types of obesity and chronic diseases. Methods: Residents aged 40 years or older were randomly selected using a multistage stratified cluster sampling method. Data were collected by means of face-to-face interview, physical examination, and laboratory examination. Descriptive data analyses were performed, and multiple logistic regression analyses were used to explore the adjusted association between different types of obesity and common vascular and metabolic diseases. Results: The prevalence of general obesity alone, central obesity alone and compound obesity were 0.15, 54.29, and 14.36%, respectively. The prevalence of coronary heart disease, stroke, hypertension, dyslipidemia, and diabetes mellitus was highest in the compound obesity group, and lowest in the non-obesity group. Hypertension, dyslipidemia, and diabetes mellitus were associated with compound obesity and central obesity alone [compound obesity (OR = 4.703, 95% CI: 3.714-5.956 for hypertension; OR = 4.244, 95% CI: 3.357-5.365 for dyslipidemia; OR = 4.575, 95% CI: 3.194-6.552 for diabetes mellitus); central obesity alone (OR = 2.210, 95% CI: 1.901-2.570 for hypertension; OR = 2.598, 95% CI: 2.241-3.012 for dyslipidemia; OR = 2.519, 95% CI: 1.834-3.459 for diabetes mellitus)]. Coronary heart disease was associated with compound obesity (OR = 1.761, 95% CI: 1.141-2.719) but not central obesity alone (OR = 1.409, 95% CI: 0.986-2.013). Stroke was associated with neither compound obesity (OR = 1.222, 95% CI: 0.815-1.833) nor associated with central obesity alone (OR = 1.080, 95% CI: 0.786-1.485). Conclusions: Central obesity alone and compound obesity are associated with the risk of hypertension, hyperlipidemia, and diabetes mellitus. Compound obesity but not central obesity alone is associated with the risk of coronary heart disease, but further research is needed to confirm it. There are no significant relationship between stroke and central obesity alone or compound obesity.

The Accumulation of Key Stroke Risk Factors and Its Association With the Characteristics of Subjects: A Population Based Cross Sectional Study.

Background: Evidence has shown that the greater the accumulation of risk factors for stroke, the greater the risk of stroke. Early intervention in the accumulation of risk factors for stroke can effectively reduce the incidence of stroke. The study aimed to investigate the distribution of the number of certain risk factors for stroke (hypertension, hyperlipidemia, overweight and obesity, and diabetes) and to explore the cause of the accumulation of certain stroke risk factors. Methods: A total of 4,052 participants aged 40 years or older were selected by the multistage stratified cluster sampling method in Dehui City in Jilin province, China. Descriptive data analyses were conducted. Multiple regression analyses were used to explore the adjusted association between the accumulation of key stroke risk factors and subjects' lifestyle and demographic characteristics. Results: Overall, 84.1% of the participants in this study had one or more of the four certain risk factors for stroke. The odds ratios (ORs) and 95% confidence intervals (CIs) of having ≥1, ≥2, and ≥3 key stroke risk factors were 1.627 (1.258, 2.103), 1.446 (1.209, 1.728), and 1.394 (1.164, 1.670), respectively, for males compared to females. Similarly, the ORs and 95% CIs of having ≥1, ≥2, and ≥3 key stroke risk factors were 1.227 (1.009, 1.492), 1.256 (1.096, 1.442), and 1.450 (1.262, 1.667), respectively, for partially salty diets compared to normal diets. Compared to people who did not exercise regularly, the ORs and 95% CIs of having ≥1, ≥2, and ≥3 key stroke risk factors were 0.693 (0.544, 0.883), 0.800 (0.679, 0.944), and 0.775 (0.659, 0.913), respectively, for people who regularly exercised. Compared to people who without a family history of cerebrovascular diseases, the ORs and 95% CIs were 1.418 (1.162, 1.732), 1.327 (1.154, 1.525), and 1.209 (1.050, 1.393), for people who with it. Conclusions: Male, partially salty diets, and family history of cerebrovascular diseases were risk factors for the accumulation of certain stroke risk factors while regular physical exercise was a protective factor.

Prevalence and risk factors for diabetes and impaired fasting glucose in Northeast China: Results from the 2016 China National Stroke Screening Survey.

AIMS: To explore the current prevalence and risk factors for diabetes and impaired fasting glucose in Northeast China. METHODS: This study adopted the multistage stratified random cluster sampling method to obtain a representative sample of adults aged 40 years or older in Dehui City, Jilin Province, Northeast China. Diabetes and impaired fasting glucose were defined according to the 1999 World Health Organization criteria. RESULTS: A total of 4052 participants were included, with prevalence of diabetes in Northeast China of 11.2% (95% confidence interval [CI], 10.1-12.4%); that of diagnosed, 5.9% (95% CI, 5.1-6.8%); and that of impaired fasting glucose, 6.9% (95% CI, 6.0-8.0%). Among them, 52.9% were aware of their condition, 47.7% were receiving antidiabetic medication, and 75.9% had their diabetes controlled. Rural residents were more likely to have diabetes but were less inclined to be aware of and report antidiabetic treatment and to have their diabetes controlled than urban residents. CONCLUSION: Diabetes and impaired fasting glucose were highly prevalent among adults in Northeast China. However, awareness and treatment rates remained relatively low compared with those of developed countries. Health policymakers should put more basic medical and healthcare into rural areas in the future.

Free Radical Damage in Ischemia-Reperfusion Injury: An Obstacle in Acute Ischemic Stroke after Revascularization Therapy.

Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process. Free radicals lead to protein dysfunction, DNA damage, and lipid peroxidation, resulting in cell death. Additionally, free radical damage has a strong connection with inducing hemorrhagic transformation and cerebral edema, which are the major complications of revascularization therapy, and mainly influencing neurological outcomes due to the disruption of the blood-brain barrier. In order to get a better clinical prognosis, more and more studies focus on the pharmaceutical and nonpharmaceutical neuroprotective therapies against free radical damage. This review discusses the pathological mechanisms of free radicals in ischemia-reperfusion injury and adjunctive neuroprotective therapies combined with revascularization therapy against free radical damage.