Background and Purpose:The cause of moyamoya disease (MMD) remains unknown. We aimed to investigate the association between modifiable risk factors and MMD in a prospective, case-control study.Methods:Clinical and laboratory characteristics were evaluated in consecutively recruited adult patients with MMD and age-matched healthy control individuals. The potential risk factors for MMD were estimated by logistic regression analysis.Results:Our prospective study included 138 adult patients and 138 healthy control subjects. Logistic regression analyses showed that increased body mass index (odds ratio [OR], 1.121 [95% CI, 1.018–1.234]; P=0.020) and homocysteine (OR, 1.201 [95% CI, 1.081–1.334]; P=0.001) were associated with higher risk of MMD. Whereas increased albumin (OR, 1.043 [95% CI, 1.004–1.082]; P=0.028) and high-density lipoprotein cholesterol (OR, 1.043 [95% CI, 1.004–1.082]; P=0.028) were correlated with a lower risk of MMD. Furthermore, homocysteine (OR, 1.070 [95% CI, 1.010–1.134]; P=0.023) was significantly related to unilateral lesions.Conclusions:Increased body mass index and homocysteine were associated with a higher risk of MMD. In contrast, increased albumin and high-density lipoprotein cholesterol were correlated with a lower risk of MMD. Furthermore, increased homocysteine was related to a higher prevalence of unilateral MMD. More attention should be paid to the modifiable risk factors of MMD, as these might help us finding its cause and new therapeutic regimen.Registration:URL: http://www.chictr.org. Unique identifier: ChiCTR2000031412.

中文翻译：

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与烟雾病相关的可修正危险因素：病例对照研究。

背景与目的：烟雾病（MMD）的病因尚不清楚。我们的目的是在一项前瞻性病例对照研究中研究可改变的危险因素与MMD之间的关系。方法：对连续招募的成年MMD患者和年龄匹配的健康对照者的临床和实验室特征进行评估。结果：我们的前瞻性研究包括138名成年患者和138名健康对照者。Logistic回归分析显示，体重指数（比值比[OR]为1.121 [95％CI，1.018–1.234]；P = 0.020）和同型半胱氨酸（OR为1.201 [95％CI，1.081–1.334]；P= 0.001）与更高的MMD风险相关。而白蛋白升高（OR，1.043 [95％CI，1.004–1.082]；P = 0.028）和高密度脂蛋白胆固醇（OR，1.043 [95％CI，1.004–1.082]；P = 0.028）与较低水平相关MMD的风险。此外，高半胱氨酸（OR，1.070 [95％CI，1.010-1.134]；P= 0.023）与单侧病变显着相关。结论：体重指数和同型半胱氨酸水平升高与MMD风险增加相关。相反，白蛋白增加和高密度脂蛋白胆固醇与MMD风险降低相关。此外，同型半胱氨酸水平升高与单侧MMD患病率升高有关。应更加注意MMD的可改变危险因素，因为这些可能有助于我们发现其原因和新的治疗方案。注册：URL：http://www.chictr.org。唯一标识符：ChiCTR2000031412。