Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with Type 2 diabetes

Li, Ting; Wu, Xiujuan; Chen, Xiaomin; Wang, Si-bo; Liu, Kang-ding; Xing, Yingqi

doi:10.4103/1673-5374.219046

Cited by 12 publications

(9 citation statements)

References 47 publications

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“…We should discuss the corresponding relationship between the risk of fatal stroke occurrence and pre-existing chronic low-grade systemic inflammation. Because the GBCS collected a series of data from relatively healthy elderly individuals in South China, each appointment was made in advance to ensure the participant’s health and that each participant was able to come the designated place by himself/herself [ 32 , 41 ]. To avoid missing important patterns in the relationship between the WBC count and incident fatal stroke, restricted cubic splines were employed, and the analysis showed a relationship between the WBC count on a continuous scale and a U-shaped risk of fatal all stroke occurrence, with high WBC counts being more related to an increased risk than low WBC counts.…”

Section: Discussionmentioning

confidence: 99%

Higher total white blood cell and neutrophil counts are associated with an increased risk of fatal stroke occurrence: the Guangzhou biobank cohort study

Zhu

et al. 2021

BMC Neurol

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Background Chronic inflammatory diseases are linked to an increased risk of stroke events. The white blood cell (WBC) count is a common marker of the inflammatory response. However, it is unclear whether the WBC count, its subpopulations and their dynamic changes are related to the risk of fatal stroke in relatively healthy elderly population. Methods In total, 27,811 participants without a stroke history at baseline were included and followed up for a mean of 11.5 (standard deviation = 2.3) years. After review of available records, 503 stroke deaths (ischaemic 227, haemorrhagic 172 and unclassified 104) were recorded. Cox proportional hazards regression was used to assess the associations between the WBC count, its subpopulations and their dynamic changes (two-phase examination from baseline to the 1st follow-up) and the risk of fatal all stroke, fatal ischaemic stroke and fatal haemorrhagic stroke. Results (i) Regarding the WBC count in relation to the risk of fatal stroke, restricted cubic splines showed an atypically U-curved association between the WBC count and the risk of fatal all stroke occurrence. Compared with those in the lowest WBC count quartile (< 5.3*10^9/L), the participants with the highest WBC count (> 7.2*10^9/L) had a 53 and 67% increased risk for fatal all stroke (adjusted hazard ratio [aHR] = 1.53, 95% confidence interval (CI) 1.16–2.02, P = 0.003) and fatal haemorrhagic stroke (aHR = 1.67, 95% CI 1.10–2.67, P = 0.03), respectively; compared with those in the lowest quartile (< 3.0*10^9/L), the participants with the highest NEUT count (> 4.5*10^9/L) had a 45 and 65% increased risk for fatal all stroke (aHR = 1.45, 95% CI 1.10–1.89, P = 0.008) and fatal ischaemic stroke (aHR = 1.65, 95%CI 1.10–2.47 P = 0.02), respectively. With the additional adjustment for C-reactive protein, the same results as those for all stroke and ischaemic stroke, but not haemorrhagic stroke, were obtained for the WBC count (4 ~ 10*10^9/L) and the NEUT count (the NEUT counts in the top 1% and bottom 1% at baseline were excluded). (ii) Regarding dynamic changes in the WBC count in relation to the risk of fatal stroke, compared with the stable group (− 25% ~ 25%, dynamic changes from two phases of examination (baseline, from September 1st, 2003 to February 28th, 2008; 1st follow-up, from March 31st 2008 to December 31st 2012)), the groups with a 25% increase in the WBC count and NEUT count respectively had a 60% (aHR = 1.60, 95% CI 1.07–2.40, P = 0.02) and 45% (aHR = 1.45, 95% CI1.02–2.05, P = 0.04) increased risk of fatal all stroke occurrence. Conclusions The WBC count, especially the NEUT count, was associated with an increased risk of fatal all stroke occurrence. Longitudinal changes in the WBC count and NEUT count increase in excess of 25% were also associated with an increased risk of fatal all stroke occurrence in the elderly population.

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Section: Discussionmentioning

confidence: 99%

Higher total white blood cell and neutrophil counts are associated with an increased risk of fatal stroke occurrence: the Guangzhou biobank cohort study

Zhu

et al. 2021

BMC Neurol

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“… 11 In addition, the plasma levels of chemerin and adiponectin have been considered as risk factors of atherosclerosis and cardiovascular diseases. 10 , 11 , 33 , 36 Furthermore, ABI and ba‐PWV levels are crucial risk factors for cardiovascular diseases in patients with T2DM, 13 , 37 which should be considered for better prediction of atherosclerosis in T2DM patients. Thus, our data provide more support for utilizing chemerin and adiponectin levels as potential markers for vascular stiffness, together with ABI levels to better predict the early stage of atherosclerosis, and even for cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

Plasma levels of adiponectin and chemerin are associated with early stage of atherosclerosis in older adults with type 2 diabetes mellitus

Zhan

Liao

et al. 2019

Aging Medicine

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Objective Adipokines, such as adiponectin and chemerin, regulate fat metabolism and are critical for the development of atherosclerosis. Investigating the correlations of adiponectin and chemerin with atherosclerosis in older adults with type 2 diabetes mellitus (T2DM) will shed light on the search for new markers for early diagnosis of diabetic atherosclerosis. Methods A total of 120 older T2DM patients and nine healthy controls were enrolled in this study. The clinical parameters, such as brachial‐ankle pulse wave velocity (ba‐PWV), adiponectin, and chemerin, were examined and recorded. T2DM subjects were divided into three groups according to ba‐PWV level (high, medium, or low). The data were processed and analyzed by identical methods. Results Significantly higher chemerin and lower adiponectin levels were detected in the plasma of T2DM patients than in healthy controls. The plasma levels of chemerin and adiponectin were negatively correlated in T2DM patients. Moreover, chemerin and adiponectin were significantly correlated with body mass index, ankle‐brachial index, insulin, and ba‐PWV. Multiple linear regression analysis revealed that chemerin and adiponectin were independently affecting ba‐PWV. Conclusion Adiponectin and chemerin are potential markers for diagnosis and monitoring of early stage of atherosclerosis in older adults with T2DM. Further clinical investigations are required to confirm these markers.

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“…We present a corresponding relation of stroke mortality risks with pre-existing chronic low-grade systemic in ammation. For the GBCS to collect a series of data from relatively healthy elderly individuals in South China, each appointment was made in advance to ensure good health and for each participant to be able to report in person to the designated place [32,41,42]. In addition, we excluded those with WBC levels at the top and bottom to avoid intervention in acute in ammatory reactions.…”

Section: Discussionmentioning

confidence: 99%

Higher Total White Blood Cell and Neutrophil Counts Are Associated With Increased Stroke Mortality Risk: The Guangzhou Biobank Cohort Study

Zhang

Zhu

et al. 2021

Preprint

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Background: To investigate the relations of white blood cell (WBC) count and its dynamic change with future stroke mortality risk in a relatively healthy elderly population.Methods: A total of 27811 participants without stroke history at baseline were included and followed up for an average of 11.5 (SD=2.3) years. After review of available records, 399 stroke (277 ischaemic and 172 haemorrhagic) deaths were recorded among all-cause mortality. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: Compared with the lowest quartile, the highest quartile of WBC count showed 53% and 67% increased mortality risk for total (adjusted HR [aHR]=1.53, 95% CI 1.16-2.02, P=0.003) and haemorrhagic (aHR=1.67, 95% CI 1.10-2.67, P=0.03) stroke, respectively; the highest neutrophil count showed 45% and 65% increased mortality risk for total (aHR=1.45, 95% CI 1.10-1.89, P=0.008) and ischaemic (aHR=1.65, 95% CI 1.10-2.47 P=0.02) stroke. The same results found for total and ischaemic stroke but not for haemorrhagic stroke were observed for both WBCs and neutrophils within the normal range level after further C-reactive protein (CRP) adjustment. Compared with the stable group, the 25% increased groups of both WBCs (aHR=1.60, 95% CI 1.07-2.40, P=0.02) and neutrophils (aHR=1.45, 95% CI 1.02-2.05, P =0.04) showed 60% and 45% increased stroke mortality risk, respectively.Conclusions: These findings support the role of WBCs, especially neutrophils, as simple, inexpensive and readily available predictors of future stroke mortality in an elderly population. Trial registration: The Guangzhou Medical Ethics Committee of the Chinese Medical Association approved the study.

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Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with Type 2 diabetes

Cited by 12 publications

References 47 publications

Higher total white blood cell and neutrophil counts are associated with an increased risk of fatal stroke occurrence: the Guangzhou biobank cohort study

Higher total white blood cell and neutrophil counts are associated with an increased risk of fatal stroke occurrence: the Guangzhou biobank cohort study

Plasma levels of adiponectin and chemerin are associated with early stage of atherosclerosis in older adults with type 2 diabetes mellitus

Higher Total White Blood Cell and Neutrophil Counts Are Associated With Increased Stroke Mortality Risk: The Guangzhou Biobank Cohort Study

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