Blood urea nitrogen, blood urea nitrogen to creatinine ratio and incident stroke: The Dongfeng-Tongji cohort,Atherosclerosis

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Blood urea nitrogen, blood urea nitrogen to creatinine ratio and incident stroke: The Dongfeng-Tongji cohort
Atherosclerosis ( IF 5.3 ) Pub Date : 2021-08-06 , DOI: 10.1016/j.atherosclerosis.2021.08.011
Rong Peng ₁ , Kang Liu ₁ , Wending Li ₁ , Yu Yuan ₁ , Rundong Niu ₁ , Lue Zhou ₁ , Yang Xiao ₁ , Hui Gao ₁ , Handong Yang ₂ , Chun Zhang ₃ , Xiaomin Zhang ₁ , Meian He ₁ , Tangchun Wu ₁

Affiliation

Background and aims

It remains unclear whether extreme levels of blood urea nitrogen (BUN) and BUN to creatinine ratio (BUN/Cr) can increase future risk of stroke. We conducted this study to investigate the associations of BUN and BUN/Cr with incident stroke and its subtypes.

Methods

A total of 26,835 and 26,379 participants with a mean follow-up of 7.9 years were included to investigate the associations of BUN and BUN/Cr with incident stroke, respectively. Cox proportional hazard models were used to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident stroke and its subtypes.

Results

Compared with participants in the third quintile of BUN, the adjusted HRs (95% CIs) for participants in the lowest quintile were 1.21 (1.04–1.40), 1.41 (1.18–1.68) and 1.36 (0.97–1.91) for total, ischemic and hemorrhagic stroke, respectively; while for those in the highest quintile, the corresponding HRs (95% CIs) were 1.16 (1.01–1.32), 1.30 (1.11–1.53), and 1.24 (0.90–1.71). The associations remained robust when restricting the analyses to participants within clinically normal range of BUN. For BUN/Cr, compared with participants in the third quintile, participants in the lowest quintile had significant higher risks of stroke (HRs [95% CIs] were 1.19 [1.04–1.37], 1.26 [1.07–1.48], and 1.22 [0.90–1.67] for total, ischemic and hemorrhagic stroke).

Conclusions

Both high and low levels of BUN were associated with higher risks of total and ischemic stroke. Low level of BUN/Cr was associated with excess risks of total and ischemic stroke.

中文翻译：

血尿素氮、血尿素氮与肌酐比值和卒中事件：东风-同济队列

背景和目标

目前尚不清楚极端水平的血尿素氮 (BUN) 和 BUN 与肌酐比值 (BUN/Cr) 是否会增加未来中风的风险。我们进行这项研究是为了调查 BUN 和 BUN/Cr 与卒中事件及其亚型的关联。

方法

共有 26,835 和 26,379 名参与者的平均随访时间为 7.9 年，分别用于调查 BUN 和 BUN/Cr 与卒中事件的关联。Cox 比例风险模型用于评估卒中事件及其亚型的风险比 (HR) 和 95% 置信区间 (CI)。

结果

与 BUN 第三五分位数的参与者相比，最低五分位数参与者的调整后 HR（95% CI）分别为 1.21 (1.04–1.40)、1.41 (1.18–1.68) 和 1.36 (0.97–1.91)，总的、缺血的和分别为出血性中风；而对于最高五分位数的人，相应的 HR（95% CI）为 1.16 (1.01–1.32)、1.30 (1.11–1.53) 和 1.24 (0.90–1.71)。当将分析限制在 BUN 临床正常范围内的参与者时，这些关联仍然很强大。对于 BUN/Cr，与第三五分之一的参与者相比，最低五分之一的参与者具有显着更高的卒中风险（HR [95% CI] 为 1.19 [1.04-1.37]、1.26 [1.07-1.48] 和 1.22 [0.90] –1.67] 总的、缺血性和出血性中风）。