The impact of metabolic diseases and their comorbidities for stroke in a middle-income area of China: a case-control study

Abstract

Background

There are few studies on the comorbidity of hypertension (HTN), diabetes mellitus (DM) and dyslipidemia (DLP) associated with stroke. We aimed to explore the relationship between the number of metabolic diseases and stroke and its different subtypes, and to reveal whether metabolic diseases alone or coexist can significantly increase the risk of stroke.

Methods

We completed a multi-center case-control study in Jiangxi Province, China. Neuroimaging examination was done in all cases. Controls were stroke-free adults recruited from the community in the case concentration area and matched with the cases in 1:1 ratio by age and sex. Odds ratios (OR) were calculated by conditional logistic regression.

Results

We enrolled 11,729 case-control pairs. The estimated ORs among patients with 1, 2 and 3 metabolic diseases were 3.16 (2.78–3.60), 7.11 (6.16–8.20), 12.22 (9.73–15.36), respectively after adjusting age, body mass index, urban-rural areas, cardiac disease, smoking, alcohol intake, physically active, high intake of salt, meat-biased diet, high homocysteine. The coexistence of HTN and DM (OR: 7.67), the coexistence of HTN and DLP (OR:7.58), and the coexistence of DM and DLP (OR:3.64) can all significantly increase the risk of stroke. HTN alone or combined other metabolic diseases were significantly more strongly associated with intracerebral haemorrhage than ischemic stroke.

Conclusions

The risk of stroke increased with the number of chronic metabolic diseases. It is necessary to regularly monitor blood pressure, blood sugar and blood lipids and strengthen lifestyle management and take appropriate drug interventions to prevent exposure to multiple metabolic diseases based on existing conditions.

Keywords:

• Stroke
• metabolic diseases
• comorbidity
• case-control study

Acknowledgements

We would like to thank the researchers who participated in this survey.

Author Contributions

Yuhang Wu: Conceptualization (lead); writing-original draft (lead); formal analysis (lead); writing-review and editing (equal). Xiaoyun Chen: Data curation (equal); software (equal). SongboHu: Conceptualization(supporting); formal analysis (supporting); writing-review and editing (equal). Huilie Zheng: Methodology (lead); formal analysis(supporting); writing-review and editing (equal). Yiying Chen: Conceptualization (supporting); project Administration(equal). Jie Liu: Investigation (supporting). Yan Xu: Data curation (equal); project Administration(equal). Xiaona Chen: Investigation (equal); project Administration(equal). Liping Zhu: Resuorce (equal); conceptualization (supporting); Wei Yan: Conceptualization (supporting); supervision (equal).

Data Availability Statement

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Natural Science Foundation of Jiangxi Province (grant no. 20202BABL216044). National Natural Science Foundation of China (grant no. 81960618).