Independent and combined effect of income and education attainment on the incidence of stroke events: a large-scale cohort study from rural communities in China

Ma, Ze; Zhang, Ya; Zhou, C.; Liu, Dong; Gu, Shujun; Zuo, Hui

doi:10.1080/01616412.2023.2176630

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…Another study using NHANES showed that poverty was more common among stroke survivors and was associated with lower dietary quality, which may also partly explain the protective effect of OBS only among those with higher incomes (24). In addition, educational attainment has also been shown to be significantly associated with stroke risk in previous studies (44,45). These findings were consistent with previous studies indicating a significant effect of SES on individuals with stroke, either alone or by influencing the relationship.…”

Section: Comparison With Other Studiessupporting

confidence: 82%

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Chen,

Liu,

et al. 2024

Front. Neurol.

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IntroductionThe relationship between oxidative balance score (OBS), an emerging integrative metric for assessing individual redox homeostasis, and the prevalence of stroke in the general population remains unknown. We aimed to explore these relationships in the National Health and Nutrition Examination Survey (NHANES). We investigated the relationship between the oxidative balance score (OBS) and stroke prevalence using NHANES data from 1999–2018.MethodsWe included eligible individuals from NHANES 1999–2018. OBS calculations were based on previously validated methods, and stroke diagnoses were based on self-reports in questionnaires. Multivariable logistic regression analyses were used to examine the independent associations of overall, dietary, and lifestyle OBS with stroke prevalence. In addition, restricted cubic spline (RCS), stratified analysis, and sensitivity analysis were used.ResultsWe included 25,258 participants aged 20–85 years, in which the prevalence of stroke was 2.66%. After adjusting for all confounders, overall and dietary OBS, but not lifestyle OBS, were inversely associated with the prevalence of stroke [odds ratios and 95% confidence intervals of 0.97 (0.96, 0.99) and 0.98 (0.96, 0.99) for overall and dietary OBS, respectively, both p < 0.05]. In addition, there was a dose-response relationship between overall and dietary OBS and stroke prevalence. The RCS showed that these relationships were linear. Stratified analyses indicated that socioeconomic status (SES) significantly influenced the relationship between all OBS and stroke prevalence.ConclusionDietary OBS, but not lifestyle OBS, had an inverse relationship with the prevalence of stroke in the general population. SES significantly influenced the protective effect of OBS against stroke. These findings emphasize the importance of integrated antioxidant properties from diet for stroke prevention.

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Section: Comparison With Other Studiessupporting

confidence: 82%

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Chen,

Liu,

et al. 2024

Front. Neurol.

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Sex differences in the association between plasma branched-chain amino acids and risk of ischemic stroke: A nested case-control study from China

Zhou,

Liu,

Tan

et al. 2024

Journal of Stroke and Cerebrovascular Diseases

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Detecting Potential Mediators of the Causal Effect of Education Level on The Risk of Stroke: A Two-Step, Two-Sample Multivariable Mendelian Randomization Study

Ken,

Ying,

Zheng

et al. 2024

Preprint

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Background: The effect of education level on the risk of stroke is not fully understood. The present study aimed to reveal the genetic and modifiable mediators for the effect of education level on the risk of stroke. Methods: Summary-level genetic data were obtained from GWAS consortia. Two-sample Mendelian Randomization (MR) analysis was performed to uncover the causal effect of education level on the risk of stroke, and regression-based multivariable MR (MVMR) analyses were used to explore potential mediators. Results: Genome-wide MR analyses showed that genetically determined higher education level was associated with reduced risk of stroke (Odds ratio (OR) per standard deviation (SD) increase: 0.74[95% confidence interval (CI): 0.58 to 0.94]; p = 0.013). We found instant coffee intake, never smoking status, body mass index (BMI), waist circumference (WC), waist-hip-ratio (WHR), Type-2 diabetes mellitus (T2DM), Diastolic pressure (DBP), Systolic pressure (SBP), Alanine aminotransferase (ALT), Platelet (PLT) and CTRP-1 (complement c1q tumor necrosis factor-related protein 1) had significant mediation roles in the effect of education level on the risk of stroke. The proportion of total effect mediated by these modifiable factors was 79%. Conclusion: We found many modifiable mediators had essential mediation roles in the effect of education level on the risk of stroke. Intervention on these mediators might have protective effect on the risk of stroke, which highlighted novel therapeutic targets.

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Independent and combined effect of income and education attainment on the incidence of stroke events: a large-scale cohort study from rural communities in China

Cited by 3 publications

References 45 publications

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Adherence to oxidative balance score is inversely associated with the prevalence of stroke: results from National Health and Nutrition Examination Survey 1999–2018

Sex differences in the association between plasma branched-chain amino acids and risk of ischemic stroke: A nested case-control study from China

Detecting Potential Mediators of the Causal Effect of Education Level on The Risk of Stroke: A Two-Step, Two-Sample Multivariable Mendelian Randomization Study

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