Evidence map›Paper›PMID 35127734›Full record

ArticleFrontiers in medicine2021

The Relative Contribution of Plasma Homocysteine Levels vs. Traditional Risk Factors to the First Stroke: A Nested Case-Control Study in Rural China.

Feng Zhou, Chengzhang Liu, Lijing Ye, Yukai Wang, Yan Shao, Guohua Zhang, Zhenpeng Duan, Jingjuan Chen, Jingyun Kuang, Jingyi Li and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 3 countries.

Feng ZhouDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Chengzhang LiuShenzhen Evergreen Medical Institute, Shenzhen, China.
Lijing YeState Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China.
Yukai WangDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Yan ShaoDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Guohua ZhangDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Zhenpeng DuanDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Jingjuan ChenDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Jingyun KuangDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
Jingyi LiState Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China.
Yun SongBeijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.
Lishun LiuBeijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.
Pierre ZallouaSchool of Medicine, Lebanese American University, Byblos, Lebanon.
Xiaobin WangDepartment of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States.
Xiping XuBeijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.
Chengguo ZhangDepartment of Neurology, First People's Hospital of Foshan, Foshan, China.
First People's Hospital of Foshan · CNChina Agricultural University · CNChina Pharmaceutical University · CNJohns Hopkins University · USLebanese American University · LBNational Clinical Research Center for Digestive Diseases · CNShenzhen Genoimmune Medical Institute · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApproximately 75% of Chinese hypertensive patients have elevated homocysteine (Hcy). Its implication in risk assessment and prevention of the first stroke remains an important clinical and public health question.

methodsThis study was based on a community cohort recruited from 2016 to 2018 in the rural China. To maximize cost efficiency, we used a nested case-control design, including 3,533 first stroke cases and 3,533 controls matched for age ±1 years, sex, and village. Individual associations of tHcy and traditional risk factors with the first stroke were examined, and their population-attributable risks (PARs) were estimated.

resultsThere was a significant dose-response association between first stroke and total Hcy (tHcy) levels, with adjusted odds ratios of 1.11 (95% CI: 0.97, 1.26) for tHcy 10-15 μmol/L and 1.44 (1.22, 1.69) for tHcy ≥ 15 μmol/L, all compared to tHcy < 10 μmol/L. A similar trend was found for ischemic and hemorrhagic stroke. tHcy and systolic blood pressure (SBP) were independently and additively associated with the risk of first stroke (tHcy: 1.06 [1.02, 1.1]; SBP: 1.13 [1.1, 1.16];

conclusionsElevated tHcy is the second most important contributor and acts additively with SBP to increase the risk of the first stroke. This finding underscores the importance of screening and treating elevated tHcy along with traditional risk factors to further reduce the burden of the first stroke in the high-risk populations.

Indexed as

first strokehomocysteineischemic strokepopulation attributable risksystolic blood pressure

Identifiers

PMID35127734
PMCPMC8811122
OpenAlexW4206368862

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.