| Objective: To analyze the relationship between dyslipidemia,abnormal serum creatinine and the risk of stroke,and to further explore whether there is an additive interaction between dyslipidemia and abnormal serum creatinine on the occurrence of stroke,so as to provide theoretical basis for early prevention of stroke.Methods: This cross-sectional study was based on the Northeast Rural CardioCerebrovascular Health Study.A multi-stage stratified cluster sampling scheme was used to recruit 11956 subjects aged 35 years and older from Dawa,Zhangwu and Liaoyang counties of Liaoning province between 2012 and 2013,and their detailed information was collected.On this basis,11752 subjects with stroke and normal controls were included in the study.SPSS statistical software was used for statistical analysis,and P<0.05 was considered statistically significant.The mean and its standard deviation or constituent ratio were used to describe the demographic characteristics,and the frequency and percentage were used to describe the characteristics of the people with dyslipidemia and abnormal serum creatinine.The t test and variance analysis were used to analyze the difference between the stroke group and the non-stroke group.Unconditional logistic regression analysis was used to establish a multivariate adjusted model to analyze the association of dyslipidemia and abnormal serum creatinine with the risk of stroke and major subtypes of stroke,and to further explore whether the combined effect of dyslipidemia and abnormal serum creatinine on the risk of stroke is higher than the effect of their single existence.Finally,Andersson et al.compiled an Excel table to calculate the additive interaction,and calculated the indicators of additive interaction,including the relative excess risk of interaction(RERI),the attributable proportion of interaction(AP)and the S index(SI).Additive interaction between dyslipidemia,abnormal serum creatinine and the risk of stroke was analyzed.Results: There were 1080 stroke patients in the study population.In this study,the stroke group and the non-stroke group were compared in basic related characteristics,and it was found that the dyslipidemia rate and abnormal serum creatinine rate in the stroke group were significantly higher than those in the non-stroke group,and the differences between the two groups were statistically significant except for gender and BMI.After adjusting for confounding factors,it was found that the risk of stroke and ischemic stroke in dyslipidemia group was respectively 1.346 times(OR: 1.346,95%CI: 1.180-1.535)and1.439 times(OR: 1.439,95%CI: 1.158-1.789),compared with normal group.The risk of stroke and ischemic stroke in the abnormal serum creatinine group was 1.428 times(OR:1.428,95%CI: 1.157-1.763)and 1.709 times(OR: 1.709,95%CI: 1.253-2.332)higher than that in the normal group,respectively.Further logistic regression model is established,with blood lipids/creatinine normal group as the reference,dyslipidemia/ creatinine normal group in stroke(OR: 1.287,95% CI: 1.120 1.480)and in ischemic stroke(OR: 1.392,95%CI: 1.102-1.759).The association between normal blood lipids/ abnormal creatinine group and the risk of stroke and ischemic stroke was no longer statistically significant.the dyslipidemia/abnormal creatinine group had the highest risk of stroke(OR: 2.210,95%CI:1.657-2.947)and ischemic stroke(OR: 2.569,95%CI: 1.694-3.897).In addition,according to the calculation results of interaction indicators,we found that there was an additive interaction between dyslipidemia,abnormal serum creatinine and the risk of stroke,and the adjusted RERI was 0.769,that was,the relative risk attributable to the interaction was0.769.AP was 0.348,indicating that 34.8% of all stroke cases were caused by the interaction between dyslipidemia and abnormal serum creatinine.When dyslipidemia and abnormal serum creatinine existed at the same time,the risk of stroke caused by dyslipidemia and abnormal serum creatinine was 2.743 times of the sum of the effects when the two existed alone.Conclusion: Dyslipidemia is positively correlated with the risk of stroke and ischemic stroke,also the abnormal serum creatinine and the occurrence of stroke and ischemic stroke risk is positive correlation.The risk of stroke and ischemic stroke when dyslipidemia and creatinine exist together is higher than that when dyslipidemia exists alone.There was an additive interaction between dyslipidemia and creatinine on the risk of stroke. |
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