Jing Cui, Xinman Dong, Feifei Yao, Xiaokun Wang, Yuncheng Shen, Jiayong Liu, Jin Cheng, Yuanyuan Li, Yuting Jiang, Hongqi Feng, Xiaona Liu, Chang Liu, Mang Li, Zhe Jiao, Yanhui Gao, Dianjun Sun, Wei Zhang
we revealed correlations between serum zinc level and the risk of mild IS, and Mg is associated with moderate IS for the first time. Furthermore, some unhealthy lifestyle factors were found to be mediators and/or modifiers in the associations with ion exposure under varying severity of stroke.
BACKGROUND: Stroke is the second leading cause of death worldwide. Some ions have been found to be related to stroke. However, limited study focused on the relationship between ions exposure and incident stroke with different severity as well as the uderlying mediation effects. Unraveling these associations can help to find out potentially effective prevention and control measures for stroke.
METHODS: This study identified 413 incident stroke based on the ECDRAHC (Environment and Chronic Disease in Rural Areas of Heilongjiang, China) cohort, comprising 381 ischemic stroke cases those divided into three groups according to NIHSS (NIH Stroke Scale) scoring and 32 hemorrhagic stroke cases. Levels of multiple ions in serum, like Zn, Mg, Cu, P, Fe, Ca, were determined. Moreover, comprehensive unhealthy lifestyle were enrolled in the mediating analysis between ion exposure and incident stroke on basis of the degree of severity.
RESULTS: The results indicated that Zn (72.0%), Mg (24.1%), and Cu (3.2%) had a remarkable contribution to stroke incident using WQS (Weighted Quantile Sum Regression) regression. Physical exercise (7.46%, P = 0.02) and uric acid (UA) are important mediators in the associations between circulating zinc level and mild ischemic stroke (16.42%, P < 0.01). Whereas, UA is a significant mediator in the relationship between circulating Mg level and moderate ischemic stroke (24.45%, P < 0.01). Engage in cold work (36.89%, P = 0.03) and urinary bilirubin (-39.00%, P < 0.01, 95%CI=-0.013-0.000) are crucial mediating factors in the association between circulating Cu levels and hemorrhagic stroke.
CONCLUSIONS: we revealed correlations between serum zinc level and the risk of mild IS, and Mg is associated with moderate IS for the first time. Furthermore, some unhealthy lifestyle factors were found to be mediators and/or modifiers in the associations with ion exposure under varying severity of stroke.