Abstract：
BACKGROUND: Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.
METHODS: We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.
RESULTS: Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.
CONCLUSIONS: Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.
METHODS: We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.
RESULTS: Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.
CONCLUSIONS: Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.
摘要：
背景：最近的研究报道了年轻人中缺血性卒中的发病率增加。然而,传统血管危险因素之间的关联强度尚未完全确定.
方法：我们比较了120例55岁之前进入我们中心卒中单元的首次缺血性卒中患者与600例健康非卒中对照者的人群队列研究（HERMEX），匹配性。评估的危险因素包括：高血压，肥胖，耳廓纤颤,目前吸烟,估计肾小球滤过率(eGFR)，总胆固醇,低密度脂蛋白胆固醇（LDL-C），甘油三酯，高密度脂蛋白胆固醇（HDL-C）和糖尿病。我们使用逻辑回归分析并计算了人群归因风险。我们进行了全面分析，按性别和病因亚组。
结果：使用逻辑回归分析，我们发现总的来说，显著的危险因素是：高血压（OR：1.58;95CI：1.01-2.50），心房颤动（OR：4.77；95CI：1.20-19.00），低eGFR（OR：4.74;95CI：1.3-21.94）和低HDL-C（OR：5.20;95CI：3.29-8.21），以及男性吸烟（OR：1.86；95CI：1.14-3.03）。LDL-C与卒中呈负相关。HDL-C的人群归因风险为37.8%，高血压为21.1%。就病因亚组而言，只有低HDL-C与病因不明的卒中相关.
结论：高血压，耳廓纤颤,eGFR低,和低HDL-C，加上男性吸烟，是55岁以下首次缺血性卒中患者的主要危险因素。我们认为，进一步探索低HDL-C水平的管理作为年轻中风患者预防策略的一部分将是特别有意义的。
方法：我们比较了120例55岁之前进入我们中心卒中单元的首次缺血性卒中患者与600例健康非卒中对照者的人群队列研究（HERMEX），匹配性。评估的危险因素包括：高血压，肥胖，耳廓纤颤,目前吸烟,估计肾小球滤过率(eGFR)，总胆固醇,低密度脂蛋白胆固醇（LDL-C），甘油三酯，高密度脂蛋白胆固醇（HDL-C）和糖尿病。我们使用逻辑回归分析并计算了人群归因风险。我们进行了全面分析，按性别和病因亚组。
结果：使用逻辑回归分析，我们发现总的来说，显著的危险因素是：高血压（OR：1.58;95CI：1.01-2.50），心房颤动（OR：4.77；95CI：1.20-19.00），低eGFR（OR：4.74;95CI：1.3-21.94）和低HDL-C（OR：5.20;95CI：3.29-8.21），以及男性吸烟（OR：1.86；95CI：1.14-3.03）。LDL-C与卒中呈负相关。HDL-C的人群归因风险为37.8%，高血压为21.1%。就病因亚组而言，只有低HDL-C与病因不明的卒中相关.
结论：高血压，耳廓纤颤,eGFR低,和低HDL-C，加上男性吸烟，是55岁以下首次缺血性卒中患者的主要危险因素。我们认为，进一步探索低HDL-C水平的管理作为年轻中风患者预防策略的一部分将是特别有意义的。
