Prospective Study On The Relationship Between Metabolic Diseases And Stroke In Jinchang Cohort

Objectives To confirm high risk populations of stroke by calculating the prevalence and incidence of stroke in the Jinchang Cohort,and to explore factors influencing the prevalence and incidence of stroke,in order to provide evidence-base suggestions for the health interventions in the cohort and provide scientific basis for prevention and treatment of stroke.Methods The baseline population of the Jinchang Cohort was 47,683,and the follow-up population was 32,613.Epidemiological survey data(including the general demographic characteristics,lifestyles,dietary habits and so on)and the physiological and biochemical indexes(height,weight,blood pressure and blood biochemical indexes et al.)were collected in the cohort.Through descriptive study,the prevalence and incidence of stroke in this population were reveled to found out the high riskpopulation.Then,case controll study was used to analyze the relationship between metabolic disorders and stroke,and the Logistic regression model was used to calculate the Odds Ratio(OR).After that,the Cohort study was carried out to confirm the effect of metabolic disorders on stroke,and the Cox regression model was used to calculate the Hazard Ration(HR).Finally,restricted cubic splines analysis(RCS)was used to study the dose-response relationship between metabolic indexes and the prevalence and incidence of stroke.Results 1.The crude prevalence of stroke was 1.59% in the Jinchang Cohort and the standardized prevalence was 3.99%.The crude and standardized prevalence of stroke in the males were 1.82% and 3.99% respectively,and were 1.24% and 2.54% in the females.The cumulative incidence of two years was 1.36% and the incidence density was 504.34 per 100,000 person years.The cumulative incidence and the incidence density of males were 1.58% and 788.93 per 100,000 person years respectively,while the females were 1.01% and 504.34 per 100,000 person years respectively.With age increasing,the prevalence and incidence of stroke were raising as well.There was no difference of the prevalence and incidence in the low age groups,but the difference existed in the high age groups which the prevalence and incidence of males were higher than the females.Besides,the prevalence and incidence of stroke were higher than those who were at the age between40 to 60 years old.2.The prevalence and incidence of stroke in the population with the metabolic disorders were higher than those in the normal.The prevalence and incidence of stroke in hypertensive patients were 8.62 and 6.02 times respectively higher than those without the hypertension;the prevalence and incidence of stroke in diabetic patients were 5.71 and 3.23 times respectively higher than those without diabetes;the prevalence and incidence of stroke in dyslipidemia patients were 3.58 and 2.94 times respectively higher than those without the dyslipidemia;the prevalence and incidence of stroke in the obese patients were 1.74 and 1.6 times respectively higher than those without the obesity.The prevalence and incidence of stroke in patients with two kinds of metabolic disorders were higher than those with only one,and those with three were more than ten times higher than people without metabolic disorders.3.Hypertension,diabetes and dyslipidemia were risk factors of the prevalence of stroke in both males and females,but obesity could only affect females.Hypertension,diabetes and dyslipidemia were risk factors of the incidence of stroke in the males while in the females were hypertension,dyslipidemia and obesity.The prevalence and incidence of stroke would significantly raise in the population with many kinds of metabolic disorders.4.The dose-response relationships between metabolic indexes and the prevalence and incidence of stroke were as follows: diastolic blood pressure(DBP)had a positive linear correlation dose-response relationship with the prevalence and incidence of stroke while systolic blood pressure(SBP)had non-linear correlation with the males only.Fasting blood glucose(FBG)had a positive linear correlation dose-response relationship with the males while there was not the same result in the females.BMI had a positive linear correlation dose-response relationship with the females while it was not in the males.Each subgroup of dyslipidemia had no significant dose-response relationship with the prevalence and incidence of stroke.Conclusions 1.The prevalence and incidence of stroke in Jinchang Cohort were at a high level at both home and abroad,and the incidence had the trend of getting younger.2.People with metabolic disorders were the high risk group of stroke and the more kinds of disorders,the higher prevalence and incidence of stroke.3.Hypertension,diabetes,dyslipidemia and obesity were all the cause factors of stroke,the risk of stroke increased significantly when the research objects develop multiple metabolic disorders.4.Compared with SBP,DBP can more steadily reflected the risk of stroke.The FBG levels can reflect stroke risk in male population better while the BMI levels can reflect stroke risk in the females better.However,there was no exact evidence proving that the subgroups of dyslipidemia can affect the risk of stroke.