Increased Blood Retinol Levels Are Associated With a Reduced Risk of TIA or Stroke in an Adult Population: Lifestyle Factors- and CVDs-Stratified Analysis.

Linjuan Guo,Rong Wan,Kui Hong,Ying Huang,Yang Shen

doi:10.3389/fcvm.2021.744611

Abstract

Background: Data on the existing evidence for the association between blood retinol and transient ischemic attack (TIA)/stroke risk are limited, and the results are inconclusive. This study aimed to further assess the associations between the blood retinol levels and the risk of TIA/stroke after controlling the lifestyle factors and age-related confounders.Methods: The cross-sectional data from 1,113 individuals (aged 34–84 years old) were obtained from the Midlife in the United States (MIDUS) study. The multivariable analyses were performed to investigate the association of blood retinol levels with ever and currently TIA/stroke.Results: There was an inverse association between the blood retinol levels and the risk of ever TIA or stroke (for per 1 μmol/L adjusted odds ration [OR]: 0.93; 95% CI: 0.89–0.97; for per 1-SD adjusted OR: 0.89; 95% CI: 0.83–0.96) and currently diagnosed TIA or stroke (for per 1 μmol/L adjusted OR: 0.91; 95% CI: 0.87–0.96; for per 1-SD adjusted OR: 0.84; 95% CI: 0.80–0.91) after controlling the lifestyle factors and age-related confounders. The significance of these associations was maintained after a sensitivity analysis and involving “ever chronic respiratory diseases” as a covariate. Moreover, the stratified analyses suggested that the inverse associations could be affected by overweight [body mass index (BMI) ≥ 28, kg/m2], hypertension, and diabetes.Conclusions: A significant inverse association between blood retinol and the risk of TIA or stroke was found. This inverse association did not change even after adjustment for many potential confounders. Moreover, the potential protective effect of retinol on TIA/stroke could be blunted by overweight [BMI ≥ 28, kg/m2], hypertension, and diabetes.

Highlights

A transient ischemic attack (TIA) or stroke is a global public health problem that leads to the second leading cause of death [1]
The fasting blood samples of the subjects were sent to the MIDUS Biocore laboratory for the analysis, and the blood levels, such as retinol, hemoglobin A1c, homeostasis model assessment of insulin resistance (HOMA-IR), fasting blood glucose, fasting insulin, total cholesterol, triglycerides, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, and C-reactive protein (CRP) were determined
Comparison of the effect factors between the two groups, there were significant differences in body mass index (BMI), current smoking status, number of drinking years, frequency of exercises ≥3/week, currently diagnosed TIA/stroke, and ever TIA/stroke, while there were no significant differences in age, gender, and marital status married

Summary

Introduction

A transient ischemic attack (TIA) or stroke is a global public health problem that leads to the second leading cause of death [1]. The knowledge of risk factors is an essential step in predicting and further preventing the TIA/stroke. The existing evidence has suggested that the risk factors for TIA/stroke mainly include obesity, lack of physical exercise, hyperlipidemia, smoking, drinking, hypertension, diabetes, heart disease, or others [2]. In the recent years, the effect of nutrients on the TIA/stroke risk has become the focus of scientific discussion. Data on the existing evidence for the association between blood retinol and transient ischemic attack (TIA)/stroke risk are limited, and the results are inconclusive. This study aimed to further assess the associations between the blood retinol levels and the risk of TIA/stroke after controlling the lifestyle factors and age-related confounders

Objectives

Methods

Results

Discussion

Conclusion