ABSTRACT
BACKGROUND: Atherosclerosis are well established risk factors for ischemic stroke, however the association between alcohol consumption and atherosclerosis is controversial. This study aims to explore the potential correlation between alcohol consumption and cerebral stenosis in patients with acute ischemic stroke and transient ischemic attack (TIA). METHODS: Nine hundreds and eighty-eight patients with first acute ischemic stroke attack or TIA were recruited retrospectively. Alcohol consumption was classified into five consumption categories (non-drinkers, occasional drinkers, < 140 g per week [mild drinkers], 140-279 g per week [moderate drinkers], ≥ 280 g per week [heavy drinkers]). Computed tomography angiography (CTA) and digital subtraction angiography (DSA) were utilized to assess the carotid and cerebral artery in all patients. Five-step scale for degree of stenosis was applied: normal (0, 0 points), mild (< 50%, 1 point), moderate (50-69%, 2 points), severe (70-99%, 3 points), and occlusion (100%, 4 points). RESULTS: The carotid and cerebral artery stenosis scores were positively correlated with moderate alcohol consumption (B = 1.695, P < 0.001). Compared with nondrinkers, moderate alcohol consumption had significant increasing risk of moderate carotid and cerebral artery stenosis (OR = 4.28, 95% CI: 1.47-12.49, P = 0.008) and severe stenosis (OR = 4.24, 95% CI: 1.55-11.64, P = 0.005) and occlusion (OR = 3.87, 95% CI: 1.65-9.06, P = 0.002). Compared with nondrinkers, heavy alcohol consumption patients had significant higher risk of carotid and cerebral artery occlusion (OR = 2.71, 95% CI: 1.36-5.41, P = 0.005). CONCLUSIONS: Higher alcohol consumption may associate with higher risk and more severity of carotid and cerebrovascular stenosis.
Subject(s)
Alcohol Drinking , Ischemic Attack, Transient , Ischemic Stroke , Humans , Male , Female , Middle Aged , Ischemic Attack, Transient/epidemiology , Ischemic Attack, Transient/diagnostic imaging , Alcohol Drinking/adverse effects , Alcohol Drinking/epidemiology , Risk Factors , Aged , Ischemic Stroke/epidemiology , Ischemic Stroke/etiology , Retrospective Studies , Carotid Stenosis/epidemiology , Carotid Stenosis/diagnostic imaging , Carotid Stenosis/complications , Adult , Aged, 80 and over , Computed Tomography Angiography/methodsABSTRACT
BACKGROUND: Many studies have shown that the levels of homocysteine (Hcy), vitamin B12 (Vit B12), and folate (FA) are abnormal in patients with Parkinson's disease (PD), but the results have not been consistent. Therefore, we conducted this meta-analysis to summarize the features of Hcy, Vit B12, and FA in PD patients. METHODS: A systematic literature search was conducted on PubMed, Cochrane Library, Web of Science, and Embase databases. RESULTS: A total of 71 studies were included. The analysis showed the following. (1) PD patients had significantly increased Hcy level (standardized mean difference [SMD] 0.80, 95% confidence interval [CI] [0.61, 0.99]; p < 0.001), and decreased Vit B12 (SMD -0.33, 95% CI [-0.43, -0.22]; p <0.001) and FA levels (SMD -0.13, 95% CI [-0.19, -0.06]; p < 0.001) compared to healthy controls. (2) Higher Hcy level (SMD 0.48, 95% CI [0.30, 0.67]; p < 0.001) was found in Dopaminergic medications treated PD patients than in untreated patients. (3) PD patients with cognitive impairment had higher Hcy level (SMD 0.71, 95% CI [0.50, 0.92]; p < 0.001) and lower Vit B12 (SMD -0.22, 95% CI [-0.34, -0.09]; p = 0.001) and FA levels (SMD -0.17, 95% CI [-0.29, -0.04]; p = 0.009) than those with no cognitive impairment. (4) PD patients with neuropathy had significantly increased Hcy level (SMD 0.87, 95% CI [0.43, 1.31]; p < 0.001) and decreased Vit B12 level (SMD -0.40, 95% CI [-0.81, -0.00]; p = 0.049) compared to PD patients with no neuropathy. CONCLUSIONS: In conclusion, PD patients may have higher Hcy levels and lower Vit B12 and FA levels than the healthy population. Thus, Hcy, Vit B12, and FA may play a role in cognitive impairment and neuropathy in PD patients.
