Article Figures & Data
Figures
- Figure 1
Prevalence (95% CI) of aICAS stratified by the number of metabolic syndrome components (unadjusted data). aICAS, asymptomatic intracranial arterial stenosis.
- Figure 2
Joint effects of hsCRP and MetS on the risk of aICAS. The groups are defined as follows: 00—no metabolic syndrome, hsCRP in quartiles 1–3; 10—metabolic syndrome present, hsCRP in quartiles 1–3; 01—no metabolic syndrome, hsCRP in quartile 4; 11—metabolic syndrome present, hsCRP in quartile 4. Adjusted for age, sex, coronary heart disease, MHR and NLR. aICAS, asymptomatic intracranial arterial stenosis; hsCRP, high-sensitivity C reactive protein; MetS, metabolic syndrome; MHR, monocyte-to-high-density lipoprotein-cholesterol ratio; NLR, neutrophil-lymphocyte ratio.
Tables
- Table 1
Baseline characteristics of the participants with and without MetS
Characteristics Total (n=2390) Participants without MetS (n=1664) Participants with MetS (n=726) P value Age, year 52.00 (44.00, 58.00) 51.00 (43.00, 57.00) 54.00 (46.00, 59.00) <0.001 Male, n (%) 1469 (61.46) 927 (55.71) 542 (74.66) <0.001 BMI, kg/㎡ 25.40 (23.19, 27.76) 24.41 (22.48, 26.55) 27.49 (25.78, 29.75) <0.001 Hypertension, n (%) 623 (26.07) 276 (16.59) 347 (47.80) <0.001 Diabetes mellitus, n (%) 223 (9.33) 62 (3.73) 161 (22.18) <0.001 Coronary heart disease, n (%) 69 (2.89) 38 (2.28) 31 (4.27) 0.008 Dyslipidaemia, n (%) 217 (9.08) 101 (6.07) 116 (15.98) <0.001 Smoking, n (%) 714 (29.87) 451 (27.10) 263 (36.23) <0.001 TC, mmol/L 4.89 (4.30, 5.49) 4.89 (4.30, 5.47) 4.87 (4.26, 5.58) 0.892 LDL-C, mmol/L 3.05 (2.46, 3.60) 3.06 (2.49, 3.58) 3.00 (2.36, 3.67) 0.205 ApoA1, g/L 1.41 (1.26, 1.57) 1.45 (1.29, 1.61) 1.33 (1.19, 1.48) <0.001 ApoB, g/L 0.93 (0.80, 1.09) 0.91 (0.78, 1.06) 0.99 (0.84, 1.15) <0.001 Hcy, μmol/L 12.21 (10.21, 14.94) 11.84 (9.92, 14.60) 13.00 (10.91, 15.59) <0.001 hsCRP, mg/L 0.72 (0.34, 1.50) 0.58 (0.28, 1.26) 1.05 (0.58, 2.13) <0.001 NLR 1.94 (1.54, 2.46) 1.89 (1.52, 2.43) 2.01 (1.62, 2.52) 0.001 MHR 0.24 (0.17, 0.31) 0.21 (0.16, 0.28) 0.29 (0.23, 0.36) <0.001 UA, μmol/l 341.05 (277.40, 404.48) 322.05 (265.12, 386.40) 382.30 (319.33, 433.73) <0.001 aICAS, n (%) 135 (5.65) 75 (4.51) 60 (8.26) <0.001 Number of affected arteries, n (%) <0.001 0 2255 (94.35) 1589 (95.49) 666 (91.74) 1 114 (4.77) 62 (3.73) 52 (7.16) ≥2 21 (0.88) 13 (0.78) 8 (1.10) Circulation, n (%) <0.001 No aICAS 2255 (94.35) 1589 (95.49) 666 (91.74) Posterior 46 (1.92) 18 (1.08) 28 (3.86) Anterior 80 (3.35) 50 (3.00) 30 (4.13) Both 9 (0.38) 7 (0.42) 2 (0.28) MetS-related characteristics Waistline, cm 88.00 (80.00, 94.00) 84.00 (77.00, 90.00) 94.00 (90.00, 100.00) <0.001 SBP, mmHg 127.00 (116.00, 138.00) 123.00 (113.00, 133.00) 135.00 (126.00, 145.00) <0.001 DBP, mmHg 81.00 (73.00, 89.00) 78.00 (71.00, 86.00) 87.00 (81.00, 93.00) <0.001 HDL-C, mmol/L 1.33 (1.15, 1.55) 1.41 (1.22, 1.64) 1.17 (1.03, 1.32) <0.001 TG, mmol/L 1.33 (0.92, 1.98) 1.14 (0.81, 1.49) 2.16 (1.63, 2.96) <0.001 FBG, mmol/L 4.94 (4.61, 5.45) 4.82 (4.55, 5.13) 5.66 (4.96, 6.52) <0.001 Metsss 1.22 (0.09, 2.82) 0.53 (0.00, 1.71) 2.85 (1.81, 4.54) <0.001 Metabolic syndrome (no. of components) <0.001 0 501 (20.96) 501 (30.11) 0 (0.00) 1 551 (23.05) 551 (33.11) 0 (0.00) 2 612 (25.61) 612 (36.78) 0 (0.00) 3 459 (19.21) 0 (0.00) 459 (63.22) 4 225 (9.41) 0 (0.00) 225 (30.99) 5 42 (1.76) 0 (0.00) 42 (5.79) aICAS, asymptomatic intracranial arterial stenosis; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; BMI, Body Mass Index; DBP, diastolic blood pressure; FBG, fasting blood glucose; Hcy, homocysteine; HDL-C, high-density lipoprotein cholesterol; hsCRP, hypersensitive C reactive protein; LDL-C, low-density lipoprotein cholesterol; MetS, metabolic syndrome; Metsss, metabolic syndrome severity score; MHR, monocyte-to-HDL-C ratio; NLR, neutrophil-lymphocyte ratio; SBP, systolic blood pressure; TC, total cholesterol; TG, triglycerides; UA, uric acid.
- Table 2
Univariate logistic regression analysis for associations with aICAS
Variables OR (95% CI) P value Male 0.97 (0.68~1.38) 0.968 Age ＜45 years 1.00 (reference) 45–59 years 3.42 (1.75~6.67) <0.001 ≥60 years 8.12 (4.09~16.10) <0.001 Hypertension 3.21 (2.26~4.56) <0.001 Diabetes mellitus 2.76 (1.78~4.30) <0.001 Coronary heart disease 2.98 (1.49~5.96) 0.002 Dyslipidaemia 1.37 (0.80~2.36) 0.250 Smoking 1.03 (0.70~1.50) 0.897 BMI, kg/m2 <24.00 1.00 (reference) 24.00–27.99 1.26 (0.83~1.92) 0.275 ≥28.00 1.47 (0.91~2.35) 0.112 Hcy, per SD increase 1.02 (0.85~1.19) 0.812 Quartiles of hsCRP Q1 (＜0.34) 1.00 (reference) Q2 (0.34–0.72) 1.31 (0.76~2.23) 0.327 Q3 (0.72–1.50) 1.28 (0.74~2.19) 0.373 Q4 (≥1.50) 1.98 (1.20~3.25) 0.007 Quartiles of MHR Q1 (＜0.17) 1.00 (reference) Q2 (0.17–0.26) 1.79 (1.06~3.02) 0.031 Q3 (0.26–0.31) 1.69 (1.00~2.88) 0.052 Q4 (≥0.31) 1.51 (0.88~2.60) 0.136 NLR, per SD increase 1.16 (0.99~1.34) 0.050 LDL-C, per SD increase 1.05 (0.88~1.25) 0.570 TC, per SD increase 1.02 (0.86~1.21) 0.829 ApoA1, per SD increase 0.94 (0.78~1.11) 0.466 ApoB, per SD increase 1.07 (0.90~1.27) 0.434 Metabolic syndrome 1.91 (1.34~2.71) <0.001 No. of MetS component ≤1 1.00 (reference) 2 1.72 (1.08~2.73) 0.022 3 2.34 (1.47~3.73) <0.001 ≥4 2.52 (1.47~4.30) <0.001 Metsss, per SD increase 1.38 (1.18~1.61) <0.001 Quartiles of Metsss Q1 (＜0.09) 1.00 (reference) Q2 (0.09–1.22) 1.53 (0.83~2.81) 0.169 Q3 (1.22–2.82) 2.34 (1.32~4.13) 0.003 Q4 (＞2.82) 2.96 (1.71~5.14) <0.001 aICAS, asymptomatic intracranial arterial stenosis; ApoA1, apolipoprotein A1; ApoB, apolipoprotein B; BMI, Body Mass Index; Hcy, homocysteine; hsCRP, high-sensitivity C reactive protein; LDL-C, low-density lipoprotein cholesterol; MetS, metabolic syndrome; Metsss, metabolic syndrome severity score; MHR, monocyte-to-high-density lipoprotein-cholesterol ratio; NLR, neutrophil-lymphocyte ratio; TC, total cholesterol.
- Table 3
Multivariate logistic regression analysis for associations with aICAS
Variables Model1* Model2† Model3‡ OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value Metabolic syndrome 1.70 (1.19~2.43) 0.004 1.68 (1.17~2.41) 0.005 1.68 (1.16~2.43) 0.006 No. of MetS component ≤1 Ref. Ref. Ref. 2 1.49 (0.93~2.39) 0.100 1.47 (0.91~2.36) 0.114 1.48 (0.92~2.39) 0.112 3 2.01 (1.24~3.25) 0.005 1.96 (1.21~3.18) 0.006 1.97 (1.21~3.23) 0.007 ≥4 2.10 (1.21~3.62) 0.008 2.08 (1.20~3.59) 0.009 2.10 (1.20~3.70) 0.010 P value for trend 0.001 0.002 0.002 Metsss, per SD increase 1.36 (1.16~1.61) ＜0.001 1.36 (1.16~1.61) ＜0.001 1.36 (1.15~1.61) ＜0.001 Quartiles of Metsss Q1 (＜0.09) Ref. Ref. Ref. Q2 (0.09–1.22) 1.23 (0.67~2.28) 0.507 1.24 (0.67~2.30) 0.486 1.23 (0.66~2.28) 0.513 Q3 (1.22–2.82) 1.72 (0.96~3.08) 0.066 1.72 (0.96~3.07) 0.068 1.71 (0.95~3.07) 0.073 Q4 (＞2.82) 2.35 (1.34~4.12) 0.003 2.37 (1.35~4.15) 0.003 2.34 (1.32~4.13) 0.004 P value for trend ＜0.001 ＜0.001 ＜0.001 *Model1: adjusted for sex and age.
†Model2: adjusted for Model1+ coronary artery heart disease.
‡Model3: adjusted for Model2+ hsCRP, MHR and NLR.
aICAS, asymptomatic intracranial arterial stenos; hsCRP, high-sensitivity C reactive protein; MetS, metabolic syndrome; Metsss, metabolic syndrome severity score; MHR, monocyte-to-high-density lipoprotein-cholesterol ratio; NLR, neutrophil-lymphocyte ratio.
- Table 4
Mediation analysis of hsCRP in the association between MetS and aICAS in the total sample and the subgroup
Group Total effect Indirect effect Direct effect Proportion mediated, % Coefficient (95% CI) P value Coefficient (95% CI) P value Coefficient (95% CI) P value The entire cohort* 0.030 (0.007–0.050) 0.012 0.002 (−0.000–0.010) 0.126 0.027 (0.005–0.050) 0.024 8.10% ≤65 s† 0.029 (0.007–0.050) 0.016 0.004 (0.000–0.010) 0.044 0.026 (0.003–0.050) 0.026 12.10% >65 s‡ 0.053 (−0.057–0.160) 0.380 −0.001 (−0.014–0.010) 0.840 0.054 (−0.053–0.160) 0.360 1.30% The relationship between MetS (X) and hsCRP (Y): multivariable-adjusted linear regression analysis demonstrated a significant association between MetS and hsCRP in the overall sample (β=0.45, 95% CI: 0.32 to 0.59, p<0.001) and the ≤65 years subgroup (β=0.59, 95% CI: 0.45 to 0.73, p<0.001). No significant association was observed in the >65 years subgroup in the univariable linear regression model (β=0.27, 95% CI: −0.18–0.72, p=0.249).
*The entire cohort: adjusted for sex, age, coronary artery heart disease, MHR and NLR.
†The subgroup aged ≤65 years: adjusted for sex and coronary artery heart disease.
‡The subgroup aged >65 years: adjusted for sex and MHR.
aICAS, asymptomatic intracranial arterial stenos; hsCRP, high-sensitivity C reactive protein; MetS, metabolic syndrome; MHR, monocyte-to-high-density lipoprotein-cholesterol ratio; NLR, neutrophil-lymphocyte ratio.
Supplementary data
