The Research On Gender Differences In Carotid Intima-media Thickness In Patients With Acute Cerebral Infarction

Objective and background:Cardiovascular disease and cerebrovascular diseases are the leading cause of death,atherosclerosis is the pathological basis of cardiovascular and cerebrovascular disease.Carotid atherosclerosis is the primary risk factor of acute cerebral infarction,which can lead to progression of carotid artery stenosis,occlusion,and cerebral thrombosis,and causing the presentation of acute cerebral infarction eventually.Meanwhile,subclinical atherosclerosis has a close relationship between coronary heart disease and stroke.Studies have shown that the carotid ultrasound is more sensitive in detecting subclinical atherosclerosis than coronary artery calcification score(CACS).Therefore,Carotid intima-media thickness is a simple and reliable method to reflect subclinical atherosclerosis.A great number of researches also show that carotid intima-media thickness is related to age,taditional atherosclerosis risks and genetic factors.Though gender is one of the most important factors of carotid intima-media thickness,the present clinical practice guidelines of carotid intima-media thickness and most researches about carotid intima-media thickness have not taken gender difference into consideration.In this study,patients with acute cerebral infarction were divided into two groups according to gender,which is helpful to study gender differences in carotid atherosclerosis on patients with acute cerebral infarctions and discussing the gender differences in atherosclerosis.The purpose is to provide the diagnosis and treatment for acute cerebral infarction patients with different gender.Subjects:This study selected 193 patients with acute cerebral infarction in our hospital(Hang zhou No.1 People's Hospital)from March 1,2014 to June 1,2015,including 94 male cases,mean age(66.84 ± 9.65)years old,99 female cases,average age(66.76 ± 12.05)years old.Methods:193 patients were divided into male ACI group(n=94)and female ACI group(n=99)according to their gender.The sex,age,diabetes,high blood pressure,smoking history were recorded;Homocysteine,total cholesterol(TC),triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)were measured,the carotid intima-media thickness were measured using B-mode ultrasonography.Comparing the differences between the two groups,and analyzing the gender difference factors for carotid intima-media thickness.Results:The carotid intima-media thickness was significantly thicker in male ACI group than female(p<0.001= Plasma HCY,LDL-C levels and smoking rates were higher in male ACI group compared with female(P<0.05 =.HDL-C levels were significantly(p<0.001)higher in female ACI group compared with male.Multivariable logistic regression analysis revealed that higher levels of homocysteine,LDL-C,smoking rates and lower levels of HDL-C were significantly(p<0.05)associated with male sex.Multiple linear regression analysis further uncovered that male,age,HCY and smoking were independently associated with carotid intima-media thickness.Conclusion:The carotid intima-media thickness was thicker in male ACI group than female.Plasma HCY levels,bad behavior such as smoking is closely related to the carotid intinma-media thickness,especially for male.