| Background:Stroke has been the second-leading cause of death which brings considerable challenges to the world,especially in low and low-middle income countries.Intracranial arterial stenosis(ICAS)is one of the most common causes of stroke and one of the most important risks of recurrent stroke particularly in Asians.Asymptomatic ICAS(aICAS)is the pre-disease stage of ICAS,which is also increasingly considered as a risk factor for ischemic stroke and magnifies the global burden of ICAS in previous studies.Therefore,early detection and management of aICAS are of great importance to the primary prevention of stroke.Visceral Adiposity Index(VAI)as a composite index to evaluate visceral adipose function has demonstrated to be correlated with atherosclerosis.However,the relationship between VAI and aICAS is not very clear.Objective:The objective of the present study was to explore the association between aICAS and VAI in rural dwellers in Shandong,China.Methods:Participants in this study were all from asymptomatic intracranial artery stenosis cohort study of natural population in Pingyin county,Shandong Province.The present study comprised 1942 residents aged≥40 years old who were free of clinical stroke and transient ischemic attack.Baseline examination was conducted by two phases from October 2017 to October 2018.In phases I,a questionnaire was used to collect demographic characteristics,individual disease history and lifestyle etc.Participants who completed the questionnaire were initially screened by transcranial doppler ultrasound(TCD)for the possible presence of aICAS.In phases Ⅱ,magnetic resonance angiography was performed to further diagnose aICAS in participants with a TCD diagnosis of aICAS.In addition,all participants underwent carotid ultrasound examination to confirm the presence of asymptomatic extracranial arterial stenosis.Firstly,all participants were divided into with and without aICAS groups.Mann-Whitney U test and Chisquare test were used to compare whether there were statistical differences in demographic characteristics and clinical characteristics between the two groups.Multivariate binary logistic regression model was used to analyze the correlation between VAI and aICAS,and the predictive efficacy of VAI to aICAS in different subgroups was analyzed by plotting subject operating characteristic curves and calculating the area under the curve.Results:In a total of 1942 participant,participants with aICAS had lower HDL-C levels and higher levels of cardiovascular risk factors,such as low-density lipoprotein cholesterol,triglycerides and hypersensitive C-reactive protein.In the meantime,participants with aICAS usually had a history of hypertension,diabetes mellitus and smoking habits.Obesity indices for example waist circumference,waist-to-hip ratio(WHR),Body mass index(BMI)and VAI were appreciably higher than participants without aICAS.After adjusting confounding factors,the VAI-Tertile 3(vs.VAI-Tertile 1)was associated with aICAS significantly(OR,2.15;95%CI,1.25～3.65;P=0.005).The VAI-Tertile 3 was still markedly associated with aICAS among underweight and normal weight(BMI≤23.9 kg/m2)participants(OR,3.17;95%CI,1.15～8.71;P=0.026)with AUC=0.684.Similar relationship between VAI and aICAS was obtained among participants with no-abdominal obesity(WHR<1,OR,2.03;95%CI,1.14～3.62;P=0.017).Conclusion:In this study,the possible association between VAI and aICAS was found to be positive among rural residents over 40 years of age in China.Higher level of VAI was found to be significantly associated with aICAS among participants with underweight or normal weight.which may bring additional risk stratification information for aICAS. |
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