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Comprehensive Analysis of the Global Burden and Risk Factors of Ischemic Stroke in Different Sexes from Gbd 2021 and Geo Database
Background: Ischemic stroke (IS) is a major global health concern with significant sex differences necessitating a comprehensive analysis of its burden, risk factors, and potential therapeutic biomarkers.
Methods: We analyzed IS data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), evaluated disease burden and trends, and explored risk factors by sex. Furthermore, we used least absolute shrinkage and selection operator (LASSO) regression and random forest to identify IS-associated biomarkers from Gene Expression Omnibus (GEO) datasets.
Results: Between 1990 and 2021, global IS cases increased by 87.97%, while the age-standardized incidence rate (ASIR) and mortality rate (ASMR) decreased by 15.85% and 39.60%, respectively. The ASIR is projected to increase slightly from 92.39 per 1,000,000 in 2021 to 103.48 per 100,000 by 2040. In 2021, the high-middle and middle sociodemographic index regions exhibited the highest ASIR and ASMR and the most pronounced health inequities. The global incidence and mortality rates of IS are primarily influenced by population growth and aging. In 2021, the key risk factors for IS were high systolic blood pressure, high low-density lipoprotein cholesterol, elevated fasting plasma glucose, ambient particulate matter pollution, smoking, and a sodium-heavy diet. The coronavirus disease 2019 pandemic significantly affected IS-related deaths, particularly among males. Eleven, three, and three IS biomarkers were identified in all, specifically male, and specifically female patients, respectively.
Conclusion: The global incidence of IS is continuously increasing due to population growth and aging. The disease outcomes of IS are primarily affected by lifestyle factors.
Funding: This study was mainly supported by the National Natural Science Foundation of China (82102681), the China Postdoctoral Science Foundation (2022M720722), and the Open Project of Jiangsu Province Engineering Research Center of Health Emergency (JSER2021002).
Declaration of Interest: The authors declare that they have no competing interests.
Ethical Approval: The GBD and GEO are public databases with ethically approved patient data.
Keywords: Ischemic stroke, Global Burden of Disease (GBD), Risk factors, Biomarkers
Chen, Wen-Li and LI, An-Dong and Li, Wei and Xu, Yu and Wang, Ziyi and Ji, Xinyu and Zhu, Hangju and Han, Lei and Zhu, Baoli and Wang, Hongxing and Xu, Min and Chen, Yuanfang, Comprehensive Analysis of the Global Burden and Risk Factors of Ischemic Stroke in Different Sexes from Gbd 2021 and Geo Database. Available at SSRN: https://ssrn.com/abstract=4954319 or http://dx.doi.org/10.2139/ssrn.4954319
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