Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2017

Open Access 01-12-2017 | Research article

Prevalence and risk factors of intracranial and extracranial artery stenosis in asymptomatic rural residents of 13 villages in China

Authors: Haiqiang Jin, Qing Peng, Ding Nan, Pu Lv, Ran Liu, Wei Sun, Yuming Teng, Yuanyuan Liu, Chenghe Fan, Haiying Xing, Ke Xu, Yining Huang

Published in: BMC Neurology | Issue 1/2017

Login to get access

Abstract

Background

The present study aimed to investigate the prevalence and risk factors for extracranial carotid artery stenosis (ECAS) and intracranial carotid artery stenosis (ICAS) simultaneously in asymptomatic Chinese pure rural population.

Methods

We analyzed 2589 asymptomatic subjects aged over 30 yr. by ultrasonography and transcranial Doppler simultaneously in 13 isolated villages by door-to-door investigation. Both ECAS and ICAS were defined as more than 50% stenosis. Demographics, medical history documentation, and investigation of biochemical results were performed for each subject. Univariate and multivariate logistic regression analyses were employed to assess the risk factors associated with ECAS and ICAS, respectively.

Results

One hundred twenty-two (4.7%) residents with ICAS and 56 (2.2%) with ECAS were found in 2589 subjects. Three factors emerged as independent risk factors for ICAS: age (95% confidence interval [CI] = 1.01–1.04, odds ratio [OR] = 1.07), hypertension (95% CI = 1.98–4.37, OR = 2.94), and diabetes mellitus (95% CI = 1.72–4.38, OR = 2.75). As for ECAS, five factors presented as independent risk factors: age (95% CI = 1.09–1.11, OR = 1.10), male sex (95% CI = 1.01–1.02, OR = 1.01), diabetes mellitus (95% CI = 1.10–2.12, OR = 1.53), systolic blood pressure (95% CI = 1.95–2.88, OR = 2.37), and total cholesterol (95% CI = 1.00–1.13, OR = 1.06).

Conclusions

ICAS and ECAS were relatively common among asymptomatic rural Chinese subjects. Although they shared similar risk factors, differences still existed between them.
Literature
1.
Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: part I. Circulation. 2003;108(14):1664–72.CrossRefPubMed
2.
de Weerd M, Greving JP, Hedblad B, Lorenz MW, Mathiesen EB, O'Leary DH, et al. Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis. Stroke. 2010;41(6):1294–7.CrossRefPubMedPubMedCentral
3.
4.
5.
Tsivgoulis G, Vadikolias K, Heliopoulos I, Katsibari C, Voumvourakis K, Tsakaldimi S, et al. Prevalence of symptomatic intracranial atherosclerosis in Caucasians: a prospective, multicenter, transcranial Doppler study. J Neuroimaging. 2014;24(1):11–7.CrossRefPubMed
6.
Wong KS, Huang YN, Gao S, Lam WW, Chan YL, Kay R. Intracranial stenosis in Chinese patients with acute stroke. Neurology. 1998;50(3):812–3.CrossRefPubMed
7.
8.
Famakin BM, Chimowitz MI, Lynn MJ, Stern BJ, George MG. Causes and severity of ischemic stroke in patients with symptomatic intracranial arterial stenosis. Stroke. 2009;40(6):1999–2003.CrossRefPubMedPubMedCentral
9.
Navarro JC, Mikulik R, Garami Z, Alexandrov AV. The accuracy of transcranial Doppler in the diagnosis of stenosis or occlusion of the terminal internal carotid artery. J Neuroimaging. 2004;14(4):314–8.CrossRefPubMed
10.
Mannami T, Konishi M, Baba S, Nishi N, Terao A. Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study. Stroke. 1997;28(3):518–25.CrossRefPubMed
11.
Shen Y, Wang J, Wu J, Qu W, Wang C, Gao X, et al. Elevated plasma total cholesterol level is associated with the risk of asymptomatic intracranial arterial stenosis. PLoS One. 2014;9(7):e101232.CrossRefPubMedPubMedCentral
12.
Wong KS, Li H, Chan YL, Ahuja A, Lam WW, Wong A, et al. Use of transcranial Doppler ultrasound to predict outcome in patients with intracranial large-artery occlusive disease. Stroke. 2000;31(11):2641–7.CrossRefPubMed
13.
Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis--Society of Radiologists in ultrasound consensus conference. Radiology. 2003;229(2):340–6.CrossRefPubMed
14.
Huang HW, Guo MH, Lin RJ, Chen YL, Luo Q, Zhang Y, et al. Prevalence and risk factors of middle cerebral artery stenosis in asymptomatic residents in Rongqi County, Guangdong. Cerebrovasc Dis. 2007;24(1):111–5.CrossRefPubMed
15.
Zhou Y, Li Y, Xu L, Xu J, Wang A, Gao X, et al. Asymptomatic polyvascular abnormalities in community (APAC) study in China: objectives, design and baseline characteristics. PLoS One. 2013;8(12):e84685.CrossRefPubMedPubMedCentral
16.
Bae HJ, Lee J, Park JM, Kwon O, Koo JS, Kim BK, et al. Risk factors of intracranial cerebral atherosclerosis among asymptomatics. Cerebrovasc Dis. 2007;24(4):355–60.CrossRefPubMed
17.
Lopez-Cancio E, Dorado L, Millan M, Reverte S, Sunol A, Massuet A, et al. The Barcelona-asymptomatic intracranial atherosclerosis (AsIA) study: prevalence and risk factors. Atherosclerosis. 2012;221(1):221–5.CrossRefPubMed
18.
Josse MO, Touboul PJ, Mas JL, Laplane D, Bousser MG. Prevalence of asymptomatic internal carotid artery stenosis. Neuroepidemiology. 1987;6(3):150–2.CrossRefPubMed
19.
Gorelick PB, Caplan LR, Hier DB, Parker SL, Patel D. Racial differences in the distribution of anterior circulation occlusive disease. Neurology. 1984;34(1):54–9.CrossRefPubMed
20.
Nishimaru K, McHenry LJ, Toole JF. Cerebral angiographic and clinical differences in carotid system transient ischemic attacks between American Caucasian and Japanese patients. Stroke. 1984;15(1):56–9.CrossRefPubMed
21.
Wityk RJ, Lehman D, Klag M, Coresh J, Ahn H, Litt B. Race and sex differences in the distribution of cerebral atherosclerosis. Stroke. 1996;27(11):1974–80.CrossRefPubMed
22.
Ding X, Li C, Yu K, Gao A, Xiao L, Peng F, et al. Different risk factors between intracranial and extracranial atherosclerotic stenosis in Asian population: a systematic review and meta-analysis. Int J Neurosci. 2014;124(11):834–40.CrossRefPubMed
23.
Mathiesen EB, Joakimsen O, Bonaa KH. Prevalence of and risk factors associated with carotid artery stenosis: the Tromso study. Cerebrovasc Dis. 2001;12(1):44–51.CrossRefPubMed
24.
Bang OY, Kim JW, Lee JH, Lee MA, Lee PH, Joo IS, et al. Association of the metabolic syndrome with intracranial atherosclerotic stroke. Neurology. 2005;65(2):296–8.CrossRefPubMed
25.
Rincon F, Sacco RL, Kranwinkel G, Xu Q, Paik MC, Boden-Albala B, et al. Incidence and risk factors of intracranial atherosclerotic stroke: the northern Manhattan stroke study. Cerebrovasc Dis. 2009;28(1):65–71.CrossRefPubMedPubMedCentral
26.
Su TC, Jeng JS, Chien KL, Sung FC, Hsu HC, Lee YT. Hypertension status is the major determinant of carotid atherosclerosis: a community-based study in Taiwan. Stroke. 2001;32(10):2265–71.PubMed
27.
Admani AK, Mangion DM, Naik DR. Extracranial carotid artery stenosis: prevalence and associated risk factors in elderly stroke patients. Atherosclerosis. 1991;86(1):31–7.CrossRefPubMed
28.
Salonen JT, Puska P, Tuomilehto J, Homan K. Relation of blood pressure, serum lipids, and smoking to the risk of cerebral stroke. A longitudinal study in eastern Finland. Stroke. 1982;13(3):327–33.CrossRefPubMed
29.
Kagan A, Popper JS, Rhoads GG, Yano K. Dietary and other risk factors for stroke in Hawaiian Japanese men. Stroke. 1985;16(3):390–6.CrossRefPubMed
30.
Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754–832.CrossRefPubMedPubMedCentral
31.
Lee SJ, Cho SJ, Moon HS, Shon YM, Lee KH, Kim DI, et al. Combined extracranial and intracranial atherosclerosis in Korean patients. Arch Neurol. 2003;60(11):1561–4.CrossRefPubMed
32.
Arenillas JF, Molina CA, Chacon P, Rovira A, Montaner J, Coscojuela P, et al. High lipoprotein (a), diabetes, and the extent of symptomatic intracranial atherosclerosis. Neurology. 2004;63(1):27–32.CrossRefPubMed
33.
Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(7):2160–236.CrossRefPubMed
34.
Kim BS, Jung HS, Bang OY, Chung CS, Lee KH, Kim GM. Elevated serum lipoprotein(a) as a potential predictor for combined intracranial and extracranial artery stenosis in patients with ischemic stroke. Atherosclerosis. 2010;212(2):682–8.CrossRefPubMed
35.
Kim JS, Nah HW, Park SM, Kim SK, Cho KH, Lee J, et al. Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease. Stroke. 2012;43(12):3313–8.CrossRefPubMed
Metadata
Title
Prevalence and risk factors of intracranial and extracranial artery stenosis in asymptomatic rural residents of 13 villages in China
Authors
Haiqiang Jin
Qing Peng
Ding Nan
Pu Lv
Ran Liu
Wei Sun
Yuming Teng
Yuanyuan Liu
Chenghe Fan
Haiying Xing
Ke Xu
Yining Huang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2017
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-017-0924-0

Other articles of this Issue 1/2017

BMC Neurology 1/2017 Go to the issue

Research article

Circadian course of the P300 ERP in patients with amyotrophic lateral sclerosis - implications for brain-computer interfaces (BCI)

Case report

A case of neuropsychiatric lupus Erythematosus characterized by the Owl’s eye sign: a case report

Research article

The relationship between lower limb muscle volume and body mass in ambulant individuals with bilateral cerebral palsy

Case report

Lumbar puncture as possible cause of sudden paradoxical herniation in patient with previous decompressive craniectomy: report of two cases

Case report

Intrafamilial phenotypic heterogeneity in a Taiwanese family with a MAPT p.R5H mutation: a case report and literature review

Case report

Cortical laminar necrosis in dengue encephalitis—a case report