Male Ischemic Stroke Patients Research Articles

Post-stroke sexual dysfunction in males

IntroductionSexual dysfunction (SD) is a commonly overlooked issue following ischemic stroke (IS), influenced by various risk factors including social, psychological, and biological factors. This study aims to investigate the prevalence and risk factors associated with SD in adult male patients who have experienced an IS. MethodsA descriptive observational cross-sectional study was conducted in Bogotá, Colombia, involving adult male IS patients. Sociodemographic, medical history, pharmacological history, substances consumption, and time since stroke data were collected. Clinical assessments were performed using the NIHSS score, modified Rankin score (mRankin), pain score, and mood evaluation (Beck inventories). The Arizona Sexual Experience (ASEX) scale and the frequency of sexual encounters were used to assess SD. Results50 males included, mean age 63.2 (±9.7) years. The most prevalent medical comorbidities were arterial hypertension (84%) and type 2 diabetes mellitus (DM) (46%). Anxiety or depression were identified in 48%. The mean scores for the NIHSS, mRankin, and pain were 6, 1, and 1, respectively. The average time from IS to clinical assessment was 6.5 months. Sexual dysfunction was observed in 18 (36%) subjects. Age (OR 1.12, 95% CI: 1.02–1.247) and location of the IS in the cortico-subcortical region of the parietal, temporal, or occipital lobes (OR 13.59, 95% CI: 1.58–405.784) were associated with SD. ConclusionSD affects more than one-third of male patients with IS, age, and IS location identified as key risk factors. Comprehensive assessment of sexual function should be incorporated into this patients.

Identification of cell death-related biomarkers and immune infiltration in ischemic stroke between male and female patients.

Stroke is the second leading cause of death and the third leading cause of disability worldwide, with ischemic stroke (IS) being the most prevalent. A substantial number of irreversible brain cell death occur in the short term, leading to impairment or death in IS. Limiting the loss of brain cells is the primary therapy target and a significant clinical issue for IS therapy. Our study aims to establish the gender specificity pattern from immune cell infiltration and four kinds of cell-death perspectives to improve IS diagnosis and therapy. Combining and standardizing two IS datasets (GSE16561 and GSE22255) from the GEO database, we used the CIBERSORT algorithm to investigate and compare the immune cell infiltration in different groups and genders. Then, ferroptosis-related differently expressed genes (FRDEGs), pyroptosis-related DEGs (PRDEGs), anoikis-related DEGs (ARDEGs), and cuproptosis-related DEGs (CRDEGs) between the IS patient group and the healthy control group were identified in men and women, respectively. Machine learning (ML) was finally used to generate the disease prediction model for cell death-related DEGs (CDRDEGs) and to screen biomarkers related to cell death involved in IS. Significant changes were observed in 4 types of immune cells in male IS patients and 10 types in female IS patients compared with healthy controls. In total, 10 FRDEGs, 11 PRDEGs, 3 ARDEGs, and 1 CRDEG were present in male IS patients, while 6 FRDEGs, 16 PRDEGs, 4 ARDEGs, and 1 CRDEG existed in female IS patients. ML techniques indicated that the best diagnostic model for both male and female patients was the support vector machine (SVM) for CDRDEG genes. SVM's feature importance analysis demonstrated that SLC2A3, MMP9, C5AR1, ACSL1, and NLRP3 were the top five feature-important CDRDEGs in male IS patients. Meanwhile, the PDK4, SCL40A1, FAR1, CD163, and CD96 displayed their overwhelming influence on female IS patients. These findings contribute to a better knowledge of immune cell infiltration and their corresponding molecular mechanisms of cell death and offer distinct clinically relevant biological targets for IS patients of different genders.

Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study.

PurposeLower serum vitamin D has been reported to be associated with stroke. This study aimed to analyze the risk factors of vitamin deficiency in Chinese stroke patients, and further analyze its impact in different gender and their clinical variables.Methods982 stroke patients were enrolled. Laboratory parameters such as serum vitamin D, apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB), ApoA-I/ApoB, cholesterol (CH), fibrinogen (FIB), blood glucose (Glu), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were collected and recorded. The severity of stroke was assessed by National Institute of Health Stroke Scale (NIHSS) score. Based on their serum vitamin D level, patients were divided into three groups: Vitamin D deficiency (<50 nmol/L), vitamin D insufficiency (≥50–75 nmol/L) and vitamin D sufficiency (≥75 nmol/L) and differences were compared among the three groups. Statistical analyses were done to assess the risk factors for serum vitamin D deficiency in our ischemic stroke patients.ResultsGender, NIHSS, and FIB showed significant differences among the vitamin D groups (P < 0.001 ∼ P = 0.002). The female gender (OR = 2.422, P < 0.001), severity of stroke using NIHSS (OR = 1.055, P = 0.008) and FIB (OR = 1.256, P = 0.005) were risk factors of vitamin D deficiency in ischemic stroke patients. In subgroup analysis, NIHSS was significantly associated with vitamin D deficiency in the male group (OR = 1.087, P = 0.002) and higher FIB group (OR = 1.078, P = 0.001).ConclusionsThe female gender, severity of stroke using NIHSS and FIB were risk factors for vitamin D deficiency in our incident stroke patients. NIHSS was more sensitive to vitamin D deficiency in male ischemic stroke patients. Besides, under higher FIB circumstance, the increasing NIHSS score was more related to the vitamin D deficiency. Levels of vitamin D in patients with ischemic stroke should be well monitored during the disease cascade.

Effect of cycling exercise on motor excitability and gait abnormalities in stroke patients

BackgroundThe concepts of brain excitability are still re-wiring in response to changes in environment. Ambulation is often limited in stroke patients.ObjectiveTo determine the effect of cycling exercise on motor excitability and consequences on spatiotemporal gait parameters in stroke patients.MethodsForty male ischemic stroke patients were included; their age ranged from 45 to 60 years. The patients were assigned into two equal groups: control group (GI) and study group (GII). The GI is treated by a design physical therapy program in the form of task-oriented progressive resistance exercise for lower limb muscles, and the GII is treated by the same program in addition to cycling exercise for 30 min. Treatment was conducted three times per week for 10 weeks. The excitability over motor area (Cz) was assessed by the quantitative electroencephalogram (QEEG). The spatiotemporal gait parameters were assessed by the Biodex Gait Trainer 2TM.ResultsThere was a significant increase of speed, step cycle, and step length of the affected side (P < 0.05) and a non-significant difference of step length of the non-affected side in the study group compared with that of the control group (P > 0.05). There was a significant increase of excitability over motor area (Cz) in the study group compared with that of the control group (P < 0.05).ConclusionCycling exercise has a positive effect on excitability over motor area of lower limbs and can improve gait parameters in stroke patients.

Erectile dysfunction and associated risk factors in male patients with ischemic stroke: A cross-sectional study.

Patients with ischemic stroke (IS) often suffered from the problem of erectile dysfunction (ED) and psychological disease. However, they are often ignored because these symptoms are more obvious in the convalescent stage of stroke, which affects the quality of sexual life of patients. This study aimed to investigate the incidence of ED, sexual quality of life, and mental state of patients after stroke, as well as analyze the relevant risk factors affecting their psychological status.A total of 361 IS patients were enrolled. The international erectile function index-5 scale was used to diagnose ED. Accordingly, the patients were divided into ED group and non-ED group. Magnetic resonance imaging was used to evaluate the brain lesions of patients. We assessed neurological deficits by the National Institutes of Health Stroke Scale score and patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) were used to evaluate the depression and anxiety. The differences between the ED group and the non-ED group clinical factors were compared.The response rate was 88.6% (n = 320), and more than two-thirds of patients reported ED (77.8%). Patients with ED had higher PHQ-9 (8.40 ± 4.18 vs 4.94 ± 3.73, P < .01) and GAD-7 (6.73 ± 3.56 vs 4.51 ± 3.35, P < .01) scores, were more likely to have the frontal lobe (75.1% vs 49.3%, P < .01) and lateral ventricle (69.8% vs 53.5%, P = .01) lesions, with hypertension (75.1% vs 46.5%, P < .01) and hyperlipidemia (48.2% vs 25.4%), and on antihypertensive (67.9% vs 35.25, P < .01) and hypolipidemic drug (43.4% vs 16.9%, P < .01). Multivariate logistic regression analysis showed that antihypertensive drug (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.02–6.10, P = .04), depression (OR: 1.18, 95% CI: 1.06–1.32, P < .01) and anxiety (OR: 1.13, 95% CI: 1.01–1.27, P = .04) might be the independent risk factors for ED group.ED is more common in male IS patients. Antihypertensive drug, depression and anxiety are the main factors affecting ED.

LncRNA ANRIL Expression and ANRIL Gene Polymorphisms Contribute to the Risk of Ischemic Stroke in the Chinese Han Population.

The aim of the present study was to explore the role of lncRNA ANRIL in the pathogenesis of ischemic stroke (IS) and coronary artery disease (CAD) and to determine the association between ANRIL variants and the genetic susceptibility of IS and CAD in the Chinese Han population. A genetic association study including 550 IS patients, 550 CAD patients, and 550 healthy controls was conducted. The expression levels of lncRNA ANRIL, CDKN2A, and CDKN2B were detected using qRT-PCR. Genotyping was performed by Sequenom MassARRAY on an Agena platform. Our study showed that IS patients had an increased lncRNA ANRIL expression (P = 0.002) and a decreased CDKN2A expression (P < 0.001) compared with normal controls. A significant difference with regard to the genotype distribution of rs2383207 was found between male IS patients and controls (P = 0.011). The minor allele of rs2383207 significantly increased the IS risk under a recessive model (OR = 1.52, 95% CI = 1.05-2.21, P = 0.027). The minor allele of rs1333049 was significantly associated with the risk of IS among the male patients under a recessive model (OR = 1.56, 95% CI = 1.04-2.35, P = 0.031). However, no significant association was found between the ANRIL variants and the risk of CAD (all P > 0.050). In addition, we found a decreased lncRNA ANRIL expression in IS patients who carried the GG genotype of rs1333049 compared with IS patients who carried the CC or CG genotype (P = 0.041). In summary, we found that IS patients had an increased lncRNA ANRIL expression and a decreased CDKN2A expression compared with the controls, which might play an impellent role in pathological processes of IS. The ANRIL variants rs2383207 and rs1333049 were significantly associated with the risk of IS among males but not females in the Chinese Han population.

TLR4 polymorphisms affect stroke risk and inflammatory response in Chinese ischemic stroke patients.

This study aimed to evaluate the association of the toll-like receptor 4 (TLR4) polymorphisms rs1927914, rs10759932, and rs11536889 with susceptibility to ischemic stroke (IS) and the serum levels of inflammatory cytokines. A total of 816 IS patients and 816 control subjects were genotyped using Sequenom MassARRAY technology. The serum levels of interleukin 1 beta (IL-1β), interleukin 6 (IL-6), interleukin 8 (IL-8), and tumor necrosis factor alpha (TNFα) were measured by enzyme-linked immunosorbent assay. rs1927914 was significantly associated with male IS patients in the additive model [odds ratio (OR)=0.81; 95% confidence interval (CI)=0.67-0.99; P=0.039] and in the allele model (OR=0.81; 95% CI=0.66-0.99; P=0.037). In the dominant model, rs10759932 was significantly associated with the serum TNFα level of the male IS patients [regression coefficient (β)=0.15; 95% CI=0.01-0.29; P adj=0.042]. This polymorphism was also correlated with the serum IL-8 level of female IS patients in the additive model (β=0.24; 95% CI=0.25-0.43; P adj=0.021) and in the recessive model (β=0.65; 95% CI=0.11-1.11; P adj=0.026). The TLR4 gene rs1927914 polymorphism was associated with susceptibility to IS in males. Moreover, the rs10759932 polymorphism may affect inflammatory response in IS patients.

TLR7 rs2897827 Polymorphism Affects TLR7 Gene mRNA Expression and Serum Apolipoprotein A1 Level of Ischemic Stroke Patients in a Chinese Han Population.

Stroke is a multi-factorial disorder that has become the leading cause of death and disability worldwide. Previous studies reported that TLR7 mRNA expression is associated with poor outcome of ischemic stroke (IS). This study aimed to assess whether TLR7 mRNA expression affects IS occurrence, as well as the association of TLR7 rs2897827 with susceptibility to IS and TLR7 mRNA expression and serum apolipoprotein and lipid levels in a Chinese Han population. A total of 816 stroke patients and 816 healthy controls were included in this study. mRNA expression was determined by quantitative real-time PCR. The Sequenom MassARRAY iPLEX platform was used to genotype the TLR7 rs2897827 polymorphism. TLR7 mRNA expression of the IS cases was statistically significantly higher than that of the controls in the male or female group (male, P=0.014; female, P=0.025). In the male IS cases, TLR7 mRNA expression of the T allele carriers was statistically significantly higher than that of the C allele carriers (P=0.018). However, a significant difference was not observed in the female cases (P=0.545). In either the male or female group, the distribution of genotype or allele had no statistical significance (P>0.050). The ApoA1 level of the T carriers was statistically significantly higher than the C carriers in males (t=-2.383, P=0.020); however, the ApoB and lipid levels were not associated with rs2897827 (P>0.050). In female patients, no significant difference was observed between different genotypic/allelic carriers in serum apolipoprotein and lipid levels (all P>0.050). The expression of the TLR7 gene may affect IS occurrence. TLR7 gene rs2897827 may influence TLR7 mRNA expression and the plasma ApoA1 level in male IS patients.

Plasma homocysteine levels in ischemic stroke patients with obstructive sleep apnea

To investigate the association of plasma homocysteine and OSA (obstructive sleep apnea) syndrome in ischemic stroke (IS). A total of 92 male IS patients were classified by apnea hypopnea index (AHI) into 2 groups: non-OSA group (AHI < 5/h) and OSA group (AHI > or = 5). All patients were tested for plasma homocysteine when polysomnography was finished at (14 +/- 2) d after the onset of IS. The mean level of homocysteine was significantly higher in the OSA group than that in the non-OSA group (17 +/- 5 vs 11 +/- 3 micromol/L, P < 0.01). Pearson correlation analysis revealed a positive correlation between the homocysteine level and the severity of AHI (r = 0.482, P < 0.01). Further multiple linear regression analysis showed that AHI and folate were independent predictors of homocysteine level (R2 = 0.553, P < 0.01, beta for AHI = 0.671, beta for folate = -0.256). The severity of OSA is significantly associated with an elevated level of homocysteine in IS patients. And this association is independent of other causative factors of an elevated level of homocysteine.