PT  - JOURNAL ARTICLE
AU  - Liu, Jie
AU  - Liu, Yang
AU  - Zhang, Longyou
AU  - Li, Wenbo
AU  - Zhang, Ying
AU  - Hong, Yin
AU  - Li, Juan
AU  - Duan, Yun Yun
AU  - Zheng, Huaguang
TI  - MetS in the prediction of asymptomatic intracranial arterial stenosis: the potential mediating role of hsCRP
AID  - 10.1136/svn-2024-003779
DP  - 2025 Mar 14
TA  - Stroke and Vascular Neurology
PG  - svn-2024-003779
4099  - http://svn.bmj.com/content/early/2025/03/14/svn-2024-003779.short
4100  - http://svn.bmj.com/content/early/2025/03/14/svn-2024-003779.full
AB  - Background We aimed to investigate the relationships between metabolic syndrome (MetS) and its severity score (Metsss) with asymptomatic intracranial arterial stenosis (aICAS) while also assessing the additional effect of high-sensitivity C reactive protein (hsCRP).Methods This cross-sectional study included 2390 individuals who underwent health examinations at our centre from June 2019 to August 2023. Participants received physical examinations, laboratory tests and magnetic resonance angiography evaluations. MetS was defined by the modified acknowledged criteria and quantified by Metsss. Logistic regression, interaction analysis and mediation analysis were employed.Results Among the 2390 participants, 135 (5.65%) had aICAS, and 726 (30.40%) had MetS. After adjusting for confounders, MetS was significantly associated with aICAS (OR: 1.68, 95% CI: 1.16 to 2.43, p=0.006). The prevalence of aICAS increased significantly from 3.6% to 8.6% as the number of MetS components increased. Higher quartiles of Metsss also significantly increased aICAS risk (P for trend <0.001). After multivariable adjustment, MetS (p=0.001) and elevated Metsss (p<0.001) were only associated with posterior circulation aICAS (vs anterior). Furthermore, participants with both MetS and elevated hsCRP levels had a greater risk for aICAS (OR: 2.32, 95% CI: 1.36 to 3.96, p=0.002). hsCRP mediated the association between MetS and alCAS in participants ≤65 years old.Conclusions MetS and Metsss were independently associated with the risk of aICAS. The mediating effect of hsCRP on the relationship between MetS and aICAS appears to be age-dependent. These findings offer valuable insights into clinical decision making of aICAS and further improve the primary stroke prevention.All data relevant to the study are included in the article or uploaded as supplementary information.