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Determinants of the Presence and Size of Intracranial Aneurysms in the General Population: The Rotterdam Study.
Stroke ( IF 7.8 ) Pub Date : 2020-06-10 , DOI: 10.1161/strokeaha.120.029296
Tim Y Cras 1 , Daniel Bos 2, 3, 4 , M Arfan Ikram 3 , Mervyn D I Vergouwen 5 , Diederik W J Dippel 1 , Trudy Voortman 3 , Hieab H H Adams 2, 3, 6 , Meike W Vernooij 2, 3 , Bob Roozenbeek 1, 2
Affiliation  

Background and Purpose:The prevalence of unruptured intracranial aneurysms (UIAs) in the adult population is ≈3%. Rupture of an intracranial aneurysm can have devastating consequences, which emphasizes the importance of identification of potentially modifiable determinants for the presence and size of UIAs. Our aim was to study the association of a broad spectrum of potential determinants with the presence and size of UIAs in a general adult population.Methods:Between 2005 and 2015, 5841 participants from the population-based Rotterdam Study (mean age, 64.4 years, 45.0% male) underwent brain magnetic resonance imaging (1.5T). These scans were evaluated for the presence of incidental UIAs. We determined number and volume of the UIAs. Using logistic and linear regression models, we assessed the association of cardiovascular, lifestyle and emerging inflammatory and hormonal determinants with the presence and volume of UIAs.Results:In 134 (2.3%) participants, ≥1 UIAs were detected (149 UIAs in total), with a median volume of 61.1 mm3 (interquartile range, 33.2–134.0). In multivariable models, female sex (odds ratio, 1.92 [95% CI, 1.33–2.84]), hypertension (odds ratio, 1.73 [95% CI, 1.13–2.68]), and current smoking (odds ratio, 3.75 [95% CI, 2.27–6.33]) were associated with the presence of UIAs. We found no association of alcohol use, physical activity, or diet quality with UIA presence. Finally, we found white blood cell count to relate to larger aneurysm volume (difference in volume of 33.6 mm3 per 109/L increase in white blood cell [95% CI, 3.92–63.5]).Conclusions:In this population-based study, female sex, hypertension, and smoking, but no other lifestyle determinants, were associated with the presence of UIAs. White blood cell count is associated with size of UIAs. Preventive strategies should focus on treating hypertension and promoting cessation of smoking.

中文翻译:

普通人群中颅内动脉瘤的存在和大小的决定因素:鹿特丹研究。

背景与目的:成年人口颅内动脉瘤未破裂的发生率约为3%。颅内动脉瘤破裂可能会造成毁灭性后果,这强调了识别UIAs的存在和大小的可能可改变的决定因素的重要性。我们的目的是研究一般成年人口中广泛的潜在决定因素与UIA的存在和大小之间的关系。方法:2005年至2015年,鹿特丹研究的5841名参与者(平均年龄,64.4岁, 45.0%的男性)接受了脑部磁共振成像(1.5T)。对这些扫描进行了评估,以确定是否存在附带的UIA。我们确定了UIA的数量和数量。使用logistic和线性回归模型,我们评估了心血管疾病,3(四分位数范围,33.2–134.0)。在多变量模型中,女性(比值比为1.92 [95%CI,1.33-2.84]),高血压(比值比为1.73 [95%CI,1.13-2.68])和当前吸烟(比值比为3.75 [95%]) CI,2.27–6.33])与UIA的存在相关。我们发现酒精摄入,体育锻炼或饮食质量与UIA存在无关。最后,我们发现白细胞计数与较大的动脉瘤体积有关(每10 9的体积差异为33.6 mm 3/ L增加白细胞[95%CI,3.92–63.5]。结论:在这项基于人群的研究中,女性,高血压和吸烟,但没有其他生活方式决定因素与UIA的存在相关。白细胞计数与UIA的大小相关。预防策略应集中于治疗高血压和促进戒烟。
更新日期:2020-06-23
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