Sex differences in the correlation between white matter hyperintensity and 3-month outcome in acute stroke patients
Junli Ren,
Xia Zhang,
Haobo Xie,
Xinbo Zhou,
Jiahan Xu,
Haojie Qiu,
Jielin Zhou,
Wei Xie,
Siqi Chen,
Xin Lu,
Yichuan Fan,
Dehao Yang,
Guangyong Chen
Affiliations
Junli Ren
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Xia Zhang
Department of Radiology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Haobo Xie
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Xinbo Zhou
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Jiahan Xu
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Haojie Qiu
The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
Jielin Zhou
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Wei Xie
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Siqi Chen
The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
Xin Lu
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
Yichuan Fan
Alberta Institute, Wenzhou Medical University, Wenzhou, China
Dehao Yang
Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Corresponding author. Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China.
Guangyong Chen
Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Corresponding author. Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Background: The severity of white matter hyperintensities (WMH) has been shown to be an independent predictor of poor stroke outcome, but the effect of sex on this correlation has not been investigated further. Therefore, the purpose of our study was to assess whether there was a sex difference between the severity of WMH and poor stroke outcome. Methods: This retrospective study included 449 patients with acute ischemic stroke (AIS) who received intravenous thrombolysis. WMH severity was graded based on the Fazekas scale. The association between WMH severity and stroke outcome was explored through multivariable regression analyses in men and women. Results: Among women, when dividing WMH severity into tertiles, T3 (Fazekas scale >3) had a 5.334 times higher risk for unfavorable outcomes than T1 (Fazekas scale <2) (p-trend = 0.026) in the adjusted model. In addition, moderate-severe WMH (Fazekas scale 3–6) had a 3.391 (1.151–9.991) times higher risk than none-mild WMH (Fazekas scale 0–2) (p = 0.027). Conclusions: The risk of unfavorable outcomes increased proportionally with the enlargement of the WMH severity in females, suggesting the sex-specific value of the WMH severity in optimizing the risk stratification of stroke.
