Sex difference in the correlation between carotid artery diameter and prevalence of stroke: Insights from a Chinese population

The atherosclerotic process can cause compensatory enlargement of artery diameter. However, the association between common carotid artery (CCA) diameter and stroke remains unclear.This cross-sectional study included 5668 participants ≥40 years of age residing in rural northeast China, in whom the inter-adventitial diameter of CCA was measured. The association between CCA diameter and stroke prevalence was explored using multivariate logistic regression and concentration-response relationship in females and males, respectively.CCA diameter (mm) was greater in stroke than in non-stroke populations in both males (7.73 versus [vs.] 7.49; P 0.05) and females (7.69 vs. 7.13; P 0.001). Among males, when dividing CCA diameters into quartiles, the second quartile (6.86-7.5 mm) had a 1.64 times higher risk for stroke than the bottom quartile (≤6.85 mm) (P 0.05) in the adjusted model. In females, the top quartile (7.95 mm) had a 2.08 (1.07-4.04) times higher risk than the bottom quartile (≤6.50 mm) (P 0.01) (overall trend 1.19 [1.00-1.43]). Moreover, dose-response relationship confirmed correlations between CCA diameter and stroke in females (P 0.05). The net reclassification index (NRI) and integrated discrimination index (IDI) confirmed the incremental value of CCA diameter in predicting probability of stroke in females (NRI 0.353 [95% confidence interval (CI) 0.198-0.497], P 0.001; IDI 0.004 [95% CI 0.001-0.006], P 0.01) and males (NRI 0.201 [95% CI 0.158-0.241], P 0.001; IDI 0.005 [95% CI 0.001-0.009], P 0.01).This study highlighted the incremental value of CCA diameter in optimizing risk classification and stroke prevention in a Chinese population.