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Li H, Zhu L, Zhang J, Xue J. Prevalence, sociodemographic, and clinical correlates of underweight in a sample of Chinese male alcohol-dependent patients. Alcohol Alcohol 2024; 59:agae033. [PMID: 38773873 DOI: 10.1093/alcalc/agae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/22/2024] [Accepted: 05/09/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. METHODS In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of .05. RESULTS The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03-7.80, P = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13-23.85, P = .036), SANS score (OR = 1.22, 95% CI = 1.16-1.28, P < .001), and HAMD score (OR = 1.06, 95% CI = 1.02-1.11, P = .005) were associated with underweight. CONCLUSIONS More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms.
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Affiliation(s)
- Huanfen Li
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Lifang Zhu
- Department of Pharmacy, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jie Zhang
- Department of Addiction, The Second Affiliated Hospital of Xinxiang Medical University, 207 Qianjin Road, Xinxiang MI453002, Henan, China
| | - Jun Xue
- Department of Social Affairs, Henan Normal University, 46 Jianshe Road E, Xinxiang MI453007, Henan, China
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Wei G, Lin F, Cao C, Hu H, Han Y. Non-linear dose-response relationship between body mass index and stroke risk in middle-aged and elderly Chinese men: a nationwide Longitudinal Cohort Study from CHARLS. Front Endocrinol (Lausanne) 2023; 14:1203896. [PMID: 37484946 PMCID: PMC10356587 DOI: 10.3389/fendo.2023.1203896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/07/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Body mass index (BMI) and stroke risk have been linked, but these findings are still debated. This study investigated the relationship between BMI and stroke risk in a middle-aged and elderly Chinese population. Methods This study used four waves of CHARLS data (2011, 2013, 2015, and 2018), including 12,161 participants. The CHARLS sample was obtained by multi-stage probability sampling and all participants were assessed by one-to-one interviews using a standardized questionnaire. We used a Cox proportional-hazards regression model to examine the relationship between BMI and stroke risk. We used Cox proportional hazards regression with cubic spline functions and smooth curve fitting to identify the non-linear relationship between them. A series of sensitivity analyses were also conducted. Results The multivariate Cox proportional hazards regression model identified a positive association between BMI and stroke risk (HR=1.025, 95% CI: 1.010-1.040). We also found a non-linear relationship between BMI and stroke incidence, with an inflection point at 26.63 kg/m2 for BMI. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 4.4% increase in stroke risk (HR=1.044, 95% CI: 1.019-1.069). We stratified individuals by gender to further investigate their association and found a particular non-linear relationship and saturation effect between BMI and stroke risk in men, with the inflection point at 25.94 kg/m2. Each 1 kg/m2 increase in BMI to the left of the inflection point was related to a 7.6% increase in stroke risk (HR=1.076, 95% CI 1.034-1.119). The association was linear in women, with each 1 kg/m2 increase in BMI associated with a 2.1% increase in stroke risk (HR=1.021, 95% CI 1.002, 1.040). Conclusion In men, there was a specific non-linear association and saturation effect of BMI with stroke (inflection point of 25.94 kg/m2), while in women, there was none. When males had a BMI below 25.94 kg/m2, the risk of stroke was significantly and positively associated with BMI. By controlling BMI below 25.94 kg/m2 in men, a further decrease in BMI may promote a significant reduction in stroke risk.
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Affiliation(s)
- Gang Wei
- Department of Emergency, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Feng Lin
- Department of Emergency, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Changchun Cao
- Department of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, China
| | - Haofei Hu
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
| | - Yong Han
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
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Maru N, Hino H, Utsumi T, Matsui H, Taniguchi Y, Saito T, Murakawa T. Risk factors for postoperative cerebral infarction in Lung Cancer patients: a retrospective study. J Cardiothorac Surg 2023; 18:132. [PMID: 37041555 PMCID: PMC10091688 DOI: 10.1186/s13019-023-02220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/02/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Postoperative cerebral infarction is a rare but serious complication after lung cancer surgery. We aimed to investigate the risk factors and evaluate the efficiency of our devised surgical procedure to prevent cerebral infarction. METHODS We retrospectively examined 1,189 patients who underwent a single lobectomy for lung cancer at our institution. We identified the risk factors for cerebral infarction and investigated the preventive effects of performing resection of the pulmonary vein as the last step of the surgical procedure during left upper lobectomy. RESULTS Among the 1,189 patients, we identified 5 male patients (0.4%) with postoperative cerebral infarction. All five underwent left-sided lobectomy including three upper and two lower lobectomies. Left-sided lobectomy, a lower forced expiratory volume in 1 s, and lower body mass index were associated with postoperative cerebral infarction (Ps < 0.05). The 274 patients who underwent left upper lobectomy were stratified by two procedures: lobectomy with resection of the pulmonary vein as the last step of the surgical procedure (n = 120) and the standard procedure (n = 154). The former procedure significantly shortened the length of the pulmonary vein stump when compared with the standard procedure (mean stump length: 15.1 vs. 18.6 mm, P < 0.01), and the shorter pulmonary vein might possibly prevent postoperative cerebral infarction (frequency: 0.8% vs. 1.3%, Odds ratio: 0.19, P = 0.31). CONCLUSIONS Resecting the pulmonary vein as the last step during the left upper lobectomy enabled the length of the pulmonary stump to be significantly shorter, which may contribute to preventing cerebral infarction.
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Affiliation(s)
- Natsumi Maru
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
| | - Haruaki Hino
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan.
| | - Takahiro Utsumi
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
| | - Hiroshi Matsui
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
| | - Yohei Taniguchi
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
| | - Tomohito Saito
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
| | - Tomohiro Murakawa
- Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi Hirakata-shi, Osaka, Osaka, 573-1191, Japan
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Song DK, Hong YS, Sung YA, Lee H. Body mass index and stroke risk among patients with diabetes mellitus in Korea. PLoS One 2022; 17:e0275393. [PMID: 36178901 PMCID: PMC9524704 DOI: 10.1371/journal.pone.0275393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background Obesity and diabetes mellitus (DM) are both associated with cardiovascular disease. This study aimed to evaluate the association between body mass index (BMI) and stroke risk among patients with DM in Korea since relatively few studies have analyzed this area in detail. Methods We analyzed a total of 56,051 DM patients aged >30 years from the Korean National Health Insurance Service Cohort who had undergone at least one national health examination between 2002 and 2012. BMI scores were divided into six categories, while hazard ratios for stroke were calculated using Cox proportional hazard models. Results Overall stroke risk was positively associated with BMI for both men and women. For ischemic stroke, the risk was positively associated with BMI in women. However, for me, only patients with the highest BMI were at increased risk compared with patients with a BMI of 20–22.4 kg/m2. For hemorrhagic stroke, the risk was significantly associated with BMI with a U-shaped association in men. In women, only patients with the lowest BMI had an increased risk of hemorrhagic stroke compared with patients that have a BMI of 20–22.4 kg/m2. Conclusion BMI was positively associated with the overall risk of stroke among DM patients in Korea. The risk of ischemic stroke was higher in obese patients compared to overweight or normal-weight patients. However, the risk of hemorrhagic stroke was higher in slimmer patients compared with overweight or obese patients.
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Affiliation(s)
- Do Kyeong Song
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeon-Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyejin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
- * E-mail:
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Wang X, Huang Y, Chen Y, Yang T, Su W, Chen X, Yan F, Han L, Ma Y. The relationship between body mass index and stroke: a systemic review and meta-analysis. J Neurol 2022; 269:6279-6289. [PMID: 35971008 DOI: 10.1007/s00415-022-11318-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stroke is an acute cerebrovascular event closely related to brain tissue damage, and is one of the major causes of death and disability in worldwide. Various studies have reported the effects of body mass index (BMI) on the risk of stroke, but the results remain varied and these results have not been synthesized. Therefore, a meta-analysis was performed to evaluate the relationship between BMI and the risk of stroke. OBJECTIVES This systematic review was conducted to explore the relationship between BMI and the risk of stroke. METHODS PubMed, EMBASE, Web of Science and Cochrane Library, China Knowledge Resource Integrated Database (CNKI), WanFang Database, Chinese Biomedical Database (CBM), and CQVIP were comprehensively searched for studies exploring the relationship between BMI and stroke from inception to December 1, 2021. RESULTS This review included 24 studies involving 5,798,826 subjects. The results of meta-analysis showed that the pooled RR of stroke risk was 0.93 (95% confidence interval [CI] 0.82-1.06, I2 = 88.8%, P = 0.29) for the underweight group. Higher BMI (overweight or obese group) was associated with an increased overall risk of stroke, with pooled RR values of 1.25 (95% CI 1.16-1.34, I2 = 84.8%, P = 0.00) and 1.47 (95% CI: 1.02-2.11, I2 = 99.4%, P = 0.04). CONCLUSION The risk of stroke was positively correlated with BMI, and the association was stronger in male and ischemic stroke. Lowering BMI can be used as a way to prevent stroke, and for people who are overweight or obese, lowering body weight can reduce the risk of stroke.
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Affiliation(s)
- Xinyu Wang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Yanan Huang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Yanru Chen
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Wenli Su
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Xiaoli Chen
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China.
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China.
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China.
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing of Lanzhou University, Lanzhou, China.
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu Province, China.
- School of Nursing, Lanzhou University, No.28, West Yan Road, Chengguan District, Lanzhou, Gansu Province, China.
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Jia Y, Wang R, Guo D, Sun L, Shi M, Zhang K, Yang P, Zang Y, Wang Y, Liu F, Zhang Y, Zhu Z. Contribution of metabolic risk factors and lifestyle behaviors to cardiovascular disease: A mendelian randomization study. Nutr Metab Cardiovasc Dis 2022; 32:1972-1981. [PMID: 35610082 DOI: 10.1016/j.numecd.2022.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Etiologic associations between some modifiable factors (metabolic risk factors and lifestyle behaviors) and cardiovascular disease (CVD) remain unclear. To identify targets for CVD prevention, we evaluated the causal associations of these factors with coronary artery disease (CAD) and ischemic stroke using a two-sample Mendelian randomization (MR) method. METHODS AND RESULTS Previously published genome-wide association studies (GWASs) for blood pressure (BP), glucose, lipids, overweight, smoking, alcohol intake, sedentariness, and education were used to identify instruments for 15 modifiable factors. We extracted effects of the genetic variants used as instruments for the exposures on coronary artery disease (CAD) and ischemic stroke from large GWASs (N = 60 801 cases/123 504 controls for CAD and N = 40 585 cases/406 111 controls for ischemic stroke). Genetically predicted hypertension (CAD: OR, 5.19 [95% CI, 4.21-6.41]; ischemic stroke: OR, 4.92 [4.12-5.86]), systolic BP (CAD: OR, 1.03 [1.03-1.04]; ischemic stroke: OR, 1.03 [1.03-1.03]), diastolic BP (CAD: OR, 1.05 [1.05-1.06]; ischemic stroke: OR, 1.05 [1.04-1.05]), type 2 diabetes (CAD: OR, 1.11 [1.08-1.15]; ischemic stroke: OR, 1.07 [1.04-1.10]), smoking initiation (CAD: OR, 1.26 [1.18-1.35]; ischemic stroke: OR, 1.24 [1.16-1.33]), educational attainment (CAD: OR, 0.62 [0.58-0.66]; ischemic stroke: OR, 0.68 [0.63-0.72]), low-density lipoprotein cholesterol (CAD: OR, 1.55 [1.41-1.71]), high-density lipoprotein cholesterol (CAD: OR, 0.82 [0.74-0.91]), triglycerides (CAD: OR, 1.29 [1.14-1.45]), body mass index (CAD: OR, 1.25 [1.19-1.32]), and alcohol dependence (OR, 1.04 [1.03-1.06]) were causally related to CVD. CONCLUSION This systematic MR study identified 11 modifiable factors as causal risk factors for CVD, indicating that these factors are important targets for preventing CVD.
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Affiliation(s)
- Yiming Jia
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Rong Wang
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Daoxia Guo
- School of Nursing, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Lulu Sun
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Kaixin Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yuhan Zang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yu Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Fanghua Liu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
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Konishi T, Fujiogi M, Michihata N, Matsui H, Tanabe M, Seto Y, Yasunaga H. Association between body mass index and incidence of breast cancer in premenopausal women: a Japanese nationwide database study. Breast Cancer Res Treat 2022; 194:315-325. [DOI: 10.1007/s10549-022-06638-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 11/02/2022]
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8
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Wu W, Zheng X. Weight Change over 4 Years and Risk of Cardiovascular Diseases in China: The China Health and Retirement Longitudinal Study. Obes Facts 2022; 15:694-702. [PMID: 36007498 PMCID: PMC9669949 DOI: 10.1159/000526419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/04/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Previous studies had reported the impact of weight changes in middle age on the incidence of cardiovascular disease (CVD), but the results were inconsistent. In present study, we aimed to investigate the impact of a 4-year weight change on the risk of CVD in middle-aged and elderly Chinese individuals. METHODS Using nationally representative data from the China Health and Retirement Longitudinal Study, 7,530 participants (age: 58.2 ± 8.9 years) were included. Weight change was calculated by subtracting weight at baseline from that at 4-year follow-up. Weight change over 4 years was divided into 5 categories (loss ≥5 kg; loss 2-5 kg; stable (change ≤2 kg); gain 2-5 kg; and gain ≥5 kg). RESULTS During the follow-up period, a total of 758 respondents experienced CVD (including 319 stroke and 477 cardiac events). The multivariable ORs of CVD for gain ≥5 kg compared to stable weight (change ≤2 kg) was 1.50 (95% CI, 1.14-1.97) versus 1.41(1.09-1.83) for losing ≥5 kg. Multivariable-adjusted logistic regression model with restricted cubic splines showed a U-shaped association between weight change and the risk of CVD (p for nonlinearity <0.001). The significant associations did not change in subgroup and sensitivity analysis. Weight change was also associated with higher risk of stroke and cardiac events. CONCLUSION Weight changes (weight gain or loss more than 5 kg) during middle age were associated with an increased risk of CVD in middle-aged and elderly Chinese individuals.
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Affiliation(s)
- Wenyan Wu
- Institutes of Biology and Medical Sciences, Soochow University, Suzhou, China
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, China
| | - Xiaowei Zheng
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, China
- *Xiaowei Zheng,
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Arafa A, Kokubo Y, Sheerah HA, Sakai Y, Watanabe E, Li J, Honda-Kohmo K, Teramoto M, Kashima R, Koga M. Weight Change Since Age 20 and the Risk of Cardiovascular Disease Mortality: A Prospective Cohort Study. J Atheroscler Thromb 2021; 29:1511-1521. [PMID: 34803086 PMCID: PMC9529374 DOI: 10.5551/jat.63191] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aim: Weight change could have many health outcomes. This study aimed to investigate the association between weight change and mortality risk due to total cardiovascular disease (CVD), ischemic heart disease (IHD), and stroke among Japanese.
Methods: We used Suita Study data from 4,746 people aged 30-79 years in this prospective cohort study. Weight change was defined as the difference between baseline weight and weight at age 20. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of total CVD, IHD, and stroke mortality for 1) participants with a weight change (>10, 5 to 10, -5 to -10, and <-10 kg) compared to those with stable weight (-4.9 to 4.9 kg) and 2) participants who moved from one body mass index category (underweight, normal weight, or overweight) to another compared to those with normal weight at age 20 and baseline.
Results: Within a median follow-up period of 19.9 years, the numbers of total CVD, IHD, and stroke mortality were 268, 132, and 79, respectively. Weight loss of >10 kg was associated with the increased risk of total CVD mortality 2.07 (1.29, 3.32) and stroke mortality 3.02 (1.40, 6.52). Moving from normal weight at age 20 to underweight at baseline was associated with the increased risk of total CVD, IHD, and stroke mortality: 1.76 (1.12, 2.77), 2.10 (1.13, 3.92), and 2.25 (1.05, 4.83), respectively.
Conclusion: Weight loss, especially when moving from normal to underweight, was associated with the increased risk of CVD mortality.
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Affiliation(s)
- Ahmed Arafa
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.,Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University.,Department of Public Health, Faculty of Medicine, Beni-Suef University
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Haytham A Sheerah
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.,Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Yukie Sakai
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Emi Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Jiaqi Li
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.,Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Kyoko Honda-Kohmo
- Division of Preventive Healthcare, National Cerebral and Cardiovascular Center
| | - Masayuki Teramoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.,Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Rena Kashima
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center.,Public Health Division, Ibaraki Public Health Center, Osaka Prefectural Government
| | - Masatoshi Koga
- Division of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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Cui C, Wu Z, Shi Y, Xu Z, Zhao B, Zhou D, Miao X, He C, Xu X. Sex-specific association of BMI change with stroke in middle-aged and older adults with type 2 diabetes. Nutr Metab Cardiovasc Dis 2021; 31:3095-3102. [PMID: 34511289 DOI: 10.1016/j.numecd.2021.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS We aimed to evaluate the association between BMI change and stroke in middle-aged and older adults with type 2 diabetes and identify sex differences. METHODS AND RESULTS The China Health and Retirement Longitudinal Study is an ongoing national population-based cohort study. Participants aged 45 or above with type 2 diabetes were enrolled and followed for stroke incidence. BMI change was defined as BMI at 2013-BMI at 2011. Of 1774 participants (mean [SD] age in 2011, 60.23 [8.88] years), 795 (44.8 %) were men. A total of 112 incident stroke cases were confirmed up to 2018. The incidence rate of stroke was similar between men and women (6.79 % vs 5.92 %, P = 0.516). BMI increase was independently associated with an increased stroke risk (adjusted odds ratio, 1.15; 95 % CI, 1.05-1.31) in men, while this positive association was not significant in women (adjusted odds ratio, 1.12; 95 % CI, 0.98-1.29). In addition, the positive dose-response relationship between BMI increase and stroke was observed only in men. CONCLUSION Among middle-aged and older adults with type 2 diabetes, there is a sex-specific association of BMI change with stroke. An increase in BMI could result in a higher risk of incident stroke in men.
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Affiliation(s)
- Cancan Cui
- China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Zhiyuan Wu
- School of Public Health, Capital Medical University, China; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Yunke Shi
- School of Public Health, Capital Medical University, China.
| | - Zhonghang Xu
- China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Bing Zhao
- State Key Laboratory of Supramolecular Structure and Materials, Jilin University, China.
| | - Di Zhou
- School of Public Health, Capital Medical University, China.
| | - Xinlei Miao
- School of Public Health, Capital Medical University, China.
| | - Chengyan He
- China-Japan Union Hospital of Jilin University, Jilin University, China.
| | - Xuesong Xu
- China-Japan Union Hospital of Jilin University, Jilin University, China.
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11
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Wu Z, Huang Z, Lichtenstein AH, Liu Y, Chen S, Jin Y, Na M, Bao L, Wu S, Gao X. The risk of ischemic stroke and hemorrhagic stroke in Chinese adults with low-density lipoprotein cholesterol concentrations < 70 mg/dL. BMC Med 2021; 19:142. [PMID: 34130689 PMCID: PMC8207613 DOI: 10.1186/s12916-021-02014-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/20/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The risk of stroke in individuals with very low low-density lipoprotein cholesterol (LDL-C) concentrations remains high. We sought to prioritize predictive risk factors for stroke in Chinese participants with LDL-C concentrations < 70 mg/dL using a survival conditional inference tree, a machine learning method. METHODS The training dataset included 9327 individuals with LDL-C concentrations < 70 mg/dL who were free of cardiovascular diseases and did not use lipid-modifying drugs from the Kailuan I study (N = 101,510). We examined the validity of this algorithm in a second Chinese cohort of 1753 participants with LDL-C concentrations < 70 mg/dL from the Kailuan II study (N = 35,856). RESULTS During a mean 8.5-9.0-year follow-up period, we identified 388 ischemic stroke cases and 145 hemorrhagic stroke cases in the training dataset and 20 ischemic stroke cases and 8 hemorrhagic stroke cases in the validation dataset. Of 15 examined predictors, poorly controlled blood pressure and very low LDL-C concentrations (≤ 40 mg/dL) were the top hierarchical predictors of both ischemic stroke risk and hemorrhagic stroke risk. The groups, characterized by the presence of 2-3 of aforementioned risk factors, were associated with a higher risk of ischemic stroke (hazard ratio (HR) 7.03; 95% confidence interval (CI) 5.01-9.85 in the training dataset; HR 4.68, 95%CI 1.58-13.9 in the validation dataset) and hemorrhagic stroke (HR 3.94, 95%CI 2.54-6.11 in the training dataset; HR 4.73, 95%CI 0.81-27.6 in the validation dataset), relative to the lowest risk groups (presence of 0-1 of these factors). There was a linear association between cumulative average LDL-C concentrations and stroke risk. LDL-C concentrations ≤ 40 mg/dL was significantly associated with increased risk of ischemic stroke (HR 2.07, 95%CI 1.53, 2.80) and hemorrhagic stroke (HR 2.70, 95%CI 1.70, 4.30) compared to LDL-C concentrations of 55-70 mg/dL, after adjustment for age, hypertension status, and other covariates. CONCLUSION Individuals with extremely low LDL-C concentrations without previous lipid-modifying treatment could still be at high stroke risk. TRIAL REGISTRATION Chinese Clinical Trial Register, ChiCTR-TNRC-11001489 . Registered on 24-08-2011.
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Affiliation(s)
- Zhijun Wu
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, People's Republic of China
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Yesong Liu
- Department of Neurology, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Shuohua Chen
- Health Care Center, Kailuan Medical Group, Tangshan, People's Republic of China
| | - Yao Jin
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA, USA
| | - Le Bao
- Department of Statistics, The Pennsylvania State University, 109 Chandlee Lab, State College, University Park, PA, 16802, USA
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, People's Republic of China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA, USA.
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12
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Effect of Post-Stroke Rehabilitation on Body Mass Composition in Relation to Socio-Demographic and Clinical Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145134. [PMID: 32708623 PMCID: PMC7400096 DOI: 10.3390/ijerph17145134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022]
Abstract
Background and objectives: Stroke is one of the leading causes of morbidity, mortality and long-term adult disability. The aim of this study was to assess the changes in body mass composition in patients after stroke in connection with selected socio-demographic and clinical factors (sex, age, type of stroke and time from the first symptoms) following the rehabilitation process. Materials and Methods: The study group consisted of 100 post-stroke subjects who participated in a comprehensive rehabilitation program for a duration of five weeks. The measurements of body composition by a Tanita MC 780 MA analyser were performed on the day of admission to hospital, on the day of discharge (after 5 weeks) and 12 weeks after discharge from hospital. Results: It was shown that before rehabilitation (Exam I) in the study group there were significant differences in body composition relative to sex, age and time from stroke. The rates of fat mass % and visceral fat level decreased after rehabilitation (Exam II) in both males and females. Exam II, at the end hospital rehabilitation, showed lower levels of fat mass %, visceral fat level, as well as fat-free mass % and higher values of total body water % and muscle mass %. In Exam III, i.e., 12 weeks after discharge, all of the parameters retained their values. Conclusions: The study shows an association between stroke risk factors (primarily age, sex and time from the onset of the first symptoms of stroke) and body mass composition resulting from rehabilitation. The type of stroke and the effects of rehabilitation on body mass components showed no differences. Comprehensive rehabilitation had a positive effect on the body mass components.
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13
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Srithumsuk W, Kabayama M, Gondo Y, Masui Y, Akagi Y, Klinpudtan N, Kiyoshige E, Godai K, Sugimoto K, Akasaka H, Takami Y, Takeya Y, Yamamoto K, Ikebe K, Ogawa M, Inagaki H, Ishizaki T, Arai Y, Rakugi H, Kamide K. The importance of stroke as a risk factor of cognitive decline in community dwelling older and oldest peoples: the SONIC study. BMC Geriatr 2020; 20:24. [PMID: 31969126 PMCID: PMC6977260 DOI: 10.1186/s12877-020-1423-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/10/2020] [Indexed: 12/31/2022] Open
Abstract
Background Cognitive impairment is a major health concern among older and oldest people. Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during 3 years in community dwelling older and oldest people. Methods This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.
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Affiliation(s)
- Werayuth Srithumsuk
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mai Kabayama
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yuya Akagi
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Nonglak Klinpudtan
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eri Kiyoshige
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kayo Godai
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ken Sugimoto
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Takeya
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Madoka Ogawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kei Kamide
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
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14
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Shen Y, Shi L, Nauman E, Katzmarzyk PT, Price-Haywood EG, Bazzano AN, Nigam S, Hu G. Association between Body Mass Index and Stroke Risk Among Patients with Type 2 Diabetes. J Clin Endocrinol Metab 2020; 105:5570275. [PMID: 31529060 PMCID: PMC6936963 DOI: 10.1210/clinem/dgz032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/09/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT Very few studies focused on the association between body mass index (BMI) and stroke risk among patients with diabetes. OBJECTIVE We aimed to investigate the association between BMI and stroke risk in patients with type 2 diabetes. DESIGN Demographic, anthropometric, laboratory, and medication information were extracted from the National Patient-Centered Clinical Research Network common data model. PARTICIPANTS We performed a retrospective cohort study of 67 086 patients with type 2 diabetes. MAIN OUTCOME MEASURES Incident stroke including both ischemic and hemorrhagic stroke were defined. RESULTS During a mean follow up of 3.74 years. 8918 incident stroke events occurred. Multivariable-adjusted hazard ratios across different categories of BMI at baseline (18.5-24.9 [reference group], 25.0-29.9, 30.0-34.9, 35.0-39.9, and ≥40 kg/m2) were 1.00, 0.92, 0.85, 0.74, and 0.63 (Ptrend <0.001) for total stroke; 1.00, 0.93, 0.88, 0.77, and 0.65 (Ptrend <0.001) for ischemic stroke; and 1.00, 0.79, 0.50, 0.50, and 0.41 (Ptrend <0.001) for hemorrhagic stroke, respectively. When we used an updated mean value of BMI, the graded inverse association of body mass index with stroke risk did not change. This linear association was consistent among patients of different subgroups. Further sensitivity analysis excluding patients who were diagnosed stroke within 6 months after first diagnosis of type 2 diabetes or including non-smokers only also confirmed our findings. CONCLUSION The present study found an inverse association between BMI and the risk of total, ischemic, and hemorrhagic stroke among patients with type 2 diabetes. More clinical and molecular insights are still needed in explaining these findings.
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Affiliation(s)
- Yun Shen
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Lizheng Shi
- Department of Global Health Management and Policy, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | | | - Eboni G Price-Haywood
- Ochsner Health System Center for Outcomes and Health Services Research, New Orleans, LA, USA
| | - Alessandra N Bazzano
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Somesh Nigam
- Blue Cross and Blue Shield of Louisiana, Baton Rouge, LA, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Correspondence and Reprint Requests: Gang Hu, Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808.
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15
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Xiang M, Hu H, Imai T, Nishihara A, Sasaki N, Ogasawara T, Hori A, Nakagawa T, Yamamoto S, Honda T, Okazaki H, Uehara A, Yamamoto M, Miyamoto T, Kochi T, Eguchi M, Murakami T, Shimizu M, Tomita K, Nagahama S, Nanri A, Konishi M, Akter S, Kuwahara K, Kashino I, Yamaguchi M, Kabe I, Mizoue T, Kunugita N, Dohi S. Association between anthropometric indices of obesity and risk of cardiovascular disease in Japanese men. J Occup Health 2019; 62:e12098. [PMID: 31750612 PMCID: PMC6970391 DOI: 10.1002/1348-9585.12098] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/12/2019] [Accepted: 10/13/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives We aimed to compare the association of body mass index (BMI), waist circumference (WC), and waist‐to‐height ratio (WHtR) with risk of cardiovascular disease (CVD) among middle‐aged working Japanese men. Methods A nested case‐control study was performed among middle‐aged male employees who underwent periodic health checkup. A total of 241 CVD cases were identified and matched individually on age, gender, and worksite with 1205 controls. Data on BMI, WC, WHtR, smoking, hypertension, diabetes, and dyslipidemia collected at 4 years before the event/index date were retrieved. Associations between BMI, WC, WHtR, and CVD risk were assessed by using conditional logistic regression models. Results The strength of the association of BMI, WC, and WHtR with CVD risk was similar. The smoking‐adjusted odds ratio (95% confidence interval) for CVD was 1.60 (1.38‐1.85), 1.53 (1.33‐1.78), and 1.56 (1.35‐1.81) for a 1 SD unit increase in BMI, WC, and WHtR respectively. After further adjustment for hypertension, diabetes, and dyslipidemia, these associations were attenuated but remained statistically significant. Conclusions Measures of general (BMI) and abdominal (WC and WHtR) obesity were similarly associated with CVD in middle‐aged Japanese men.
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Affiliation(s)
- Mi Xiang
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Huanhuan Hu
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Naoko Sasaki
- Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan
| | | | - Ai Hori
- Department of Global Public Health, University of Tsukuba, Ibaraki, Japan
| | | | | | | | | | | | | | | | | | | | - Taizo Murakami
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | - Makiko Shimizu
- Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan
| | | | | | - Akiko Nanri
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shamima Akter
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Ikuko Kashino
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Miwa Yamaguchi
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Isamu Kabe
- Furukawa Electric Co., Ltd., Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoki Kunugita
- Department of Environmental Health, National Institute of Public Health, Saitama, Japan
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16
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Lin H, Chen C, Yeh Y, Chen Y, Guo R, Lin Y, Li Y. Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population‐based cohort study. J Clin Periodontol 2019; 46:642-649. [DOI: 10.1111/jcpe.13113] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/07/2019] [Accepted: 04/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Hsiao‐Wei Lin
- Division of Family Dentistry Changhua Christian Hospital Changhua Taiwan
| | - Chun‐Min Chen
- Research Education and Epidemiology Centre Changhua Christian Hospital Changhua Taiwan
| | - Yi‐Chun Yeh
- Research Education and Epidemiology Centre Changhua Christian Hospital Changhua Taiwan
- Department of Public Health China Medical University Taichung Taiwan
| | - Yen‐Yu Chen
- Research Education and Epidemiology Centre Changhua Christian Hospital Changhua Taiwan
- Department of Neurology Changhua Christian Hospital Changhua Taiwan
- Institute of Clinical Medicine National Yang‐Ming University Taipei Taiwan
| | - Ru‐Yu Guo
- Dental Technology Centre Changhua Christian Hospital Changhua Taiwan
| | - Yen‐Ping Lin
- Dental Technology Centre Changhua Christian Hospital Changhua Taiwan
| | - Ya‐Ching Li
- Dental Technology Centre Changhua Christian Hospital Changhua Taiwan
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17
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Li Y, Yatsuya H, Iso H, Yamagishi K, Saito I, Kokubo Y, Sawada N, Tsugane S. Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study. J Epidemiol 2018; 29:325-333. [PMID: 30555115 PMCID: PMC6680058 DOI: 10.2188/jea.je20170298] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The association of body mass index (BMI) with risks of ischemic stroke subtypes have not been established. METHODS Cumulative average BMI was calculated using self-reported body weight and height obtained from baseline (Cohort I in 1990, and Cohort II from 1993-1994) and 5- and 10-year questionnaire surveys of Japan Public Health Center-based prospective (JPHC) study. A total of 42,343 men and 46,413 women aged 40-69 years were followed-up for the incidence of lacunar, large-artery occlusive, and cardioembolic strokes. A sub-distribution hazard model was used to estimate sub-distribution hazard ratios (SHRs) and the 95% confidence intervals (CIs). RESULTS During a median of 20.0 years of follow-up, we documented 809 and 481 lacunar, 395 and 218 large-artery occlusive, and 568 and 298 cardioembolic strokes in men and women, respectively. After adjustment for baseline age, updated smoking, alcohol consumption, leisure-time physical activity, and histories of hypertension, dyslipidemia, and diabetes mellitus, cumulative average BMI was positively linearly associated with lacunar (trend P = 0.007), large-artery occlusive (trend P = 0.002), and cardioembolic (trend P < 0.001) strokes in men, and with lacunar (trend P < 0.001) and large-artery occlusive (trend P = 0.003) strokes in women. There were approximately two-fold excess risk of cardioembolic stroke in both sexes and of lacunar and large-artery occlusive strokes in women for cumulative average BMI ≥30 kg/m2 compared to BMI 23-<25 kg/m2. CONCLUSION Cumulative average BMI showed a positive linear effect on sub-distribution hazards of lacunar, large-artery occlusive, and cardioembolic strokes in both sexes, except for cardioembolic stroke in women.
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Affiliation(s)
- Yuanying Li
- Department of Public Health, Fujita Health University
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University.,Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba
| | - Isao Saito
- Program for Nursing and Health Sciences, Ehime University Graduate School of Medicine
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
| | - Norie Sawada
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center
| | - Shoichiro Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center
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18
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Alexiev F, Brill AK, Ott SR, Duss S, Schmidt M, Bassetti CL. Sleep-disordered breathing and stroke: chicken or egg? J Thorac Dis 2018; 10:S4244-S4252. [PMID: 30687540 PMCID: PMC6321898 DOI: 10.21037/jtd.2018.12.66] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022]
Abstract
The bidirectional interaction between sleep-disordered breathing (SDB) and stroke has been the subject of many studies. On the one hand, different forms of SDB, and especially obstructive sleep apnea, increase the risk of stroke either directly or indirectly by influencing other known cardiovascular risk factors such as arterial hypertension and arrhythmias. On the other hand, stroke itself can cause either de novo appearance of SDB, aggravate a pre-existing SDB, or trigger a transition from one type of pathological SDB pattern into another. In this review, we discuss some aspects of this "chicken or egg" relationship.
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Affiliation(s)
- Filip Alexiev
- University Sleep-Wake-Epilepsy Center (SWEZ), Department of NeurologyUniversity Hospital (Inselspital), Bern, Switzerland
| | - Anne-Kathrin Brill
- Department of Pulmonary Medicine, University Hospital (Inselspital), Bern, Switzerland
| | - Sebastian R. Ott
- Department of Pulmonary Medicine, University Hospital (Inselspital), Bern, Switzerland
- Department of Pulmonary Medicine and Thoracic Surgery, St. Claraspital, Basel, Switzerland
| | - Simone Duss
- University Sleep-Wake-Epilepsy Center (SWEZ), Department of NeurologyUniversity Hospital (Inselspital), Bern, Switzerland
| | - Markus Schmidt
- University Sleep-Wake-Epilepsy Center (SWEZ), Department of NeurologyUniversity Hospital (Inselspital), Bern, Switzerland
- Ohio Sleep Medicine Institute, Dublin, Ohio, USA
| | - Claudio L. Bassetti
- University Sleep-Wake-Epilepsy Center (SWEZ), Department of NeurologyUniversity Hospital (Inselspital), Bern, Switzerland
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19
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Liu X, Zhang D, Liu Y, Sun X, Hou Y, Wang B, Ren Y, Zhao Y, Han C, Cheng C, Liu F, Shi Y, Chen X, Liu L, Chen G, Hong S, Zhang M, Hu D. A J-shaped relation of BMI and stroke: Systematic review and dose-response meta-analysis of 4.43 million participants. Nutr Metab Cardiovasc Dis 2018; 28:1092-1099. [PMID: 30287124 DOI: 10.1016/j.numecd.2018.07.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM Many studies have shown increased risk of stroke with greater adiposity as measured by body mass index (BMI), but questions remain about the shape of the dose-response relation. We conducted a systematic review and meta-analysis of prospective studies to clarify the strength and shape of the dose-response relation between BMI and risk of stroke. METHODS AND RESULTS PubMed and Embase databases were searched for articles published up to May 11, 2018. Random-effects generalized least-squares regression models were used to estimate study-specific dose-response association, and restricted cubic splines were used to model the association. We included reports of 44 prospective cohort studies describing 102 466 incident cases among 4 432 475 participants. With a 5-unit increment in BMI, the summary relative risk for stroke incidence was 1.10 (95% confidence interval, 1.06 to 1.13; I2 = 88.0%). The dose-response relation was J-shaped (Pnon-linearity <0.001). The risk was not increased at the low BMI range (<24 kg/m2), but was increased within the high BMI range (>25 kg/m2). CONCLUSION Both overweight and obesity increase the risk of stroke with a J-shaped dose-response relation, and the nadir of the curve was observed at BMI 23-24 kg/m2.
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Affiliation(s)
- X Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - D Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - X Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Hou
- College of Physical Education, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - B Wang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Y Ren
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Y Zhao
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Han
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - C Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - F Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - Y Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - L Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - G Chen
- Department of Clinical Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - S Hong
- Department of Clinical Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - M Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China
| | - D Hu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
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20
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Sarbazi E, Sarbakhsh P, Savadi Oskooei D, Yazdchi M, Ghaffari-Fam S, Shamshirgaran SM. Factors related to 6-month mortality after the first-ever stroke. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:113. [PMID: 30271798 PMCID: PMC6149124 DOI: 10.4103/jehp.jehp_190_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 06/18/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND OBJECTIVE Stroke is the second leading cause of death worldwide and the number of stroke cases has increased remarkably over the last 20 years. This study aimed at identifying predictors of with 6-month mortality of first-ever stroke patients and the factors contributing to it in East Azerbaijan province. MATERIALS AND METHODS A closed cohort study was carried out from April 2014 to December 2014. All cases of first-ever diagnosed stroke were included in the study. Any transient ischemic attack, silent brain infarctions, and the stroke cases which were neither associated with trauma, blood disease nor with malignancy were excluded from the study. The variables of this study include participants' demographic characteristics, stroke severity National Institutes of Health Stroke Scale (NIHSS), and stroke risk factors. Patients were followed up within 6 months. To determine the survival time, the log-rank method was applied to compare intergroup differences. The tests include the univariate and multivariate analysis Cox regression. P < 0.05 were considered as statistically significant. RESULTS A total of 576 cases of stroke were included in this study. Average age of ischemic and hemorrhagic stroke was 70.15 ± 13.0 and 67.79 ± 12.69, respectively. Case-fatality rate (CFR) of stroke patients was 49.2 and 21.7% in hemorrhagic and ischemic stroke types, respectively. Factors contributing to stroke mortality events include the severity of stroke (NIHSS categories 15-19 and ≥20), age over 65, being female, high body mass index and hyperlipidemia. In the final model, the severity of stroke (with NIHSS 15-19 with hazard ratio (HR) 4.22 (95% confidence interval [CI] 2.36-7.56) and NIHSS ≥20 with HR 5.34 (95% CI: 2.81-10.12) and age above 65 with HR 1.61 (95% CI: 1.02-2.51) were the most important predictors of 6-month mortality. CONCLUSION Severity of stroke by NIHSS was the most prominent factor in stroke patients' mortality. By increasing the follow-up time, a better evaluation of the predictors of mortality after stroke can be achieved.
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Affiliation(s)
- Ehsan Sarbazi
- Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Daryoush Savadi Oskooei
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Yazdchi
- Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Ghaffari-Fam
- Miandoab Health Centre, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyed Morteza Shamshirgaran
- Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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21
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Hagii J, Metoki N, Saito S, Fujita A, Shiroto H, Sasaki S, Takahashi K, Hitomi H, Baba Y, Seino S, Kamada T, Uchizawa T, Iwata M, Matsumoto S, Yasujima M, Tomita H. Low Body Mass Index is a Poor Prognosis Factor in Cardioembolic Stroke Patients with NonValvular Atrial Fibrillation. J Stroke Cerebrovasc Dis 2018; 27:3155-3162. [PMID: 30093200 DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/10/2018] [Accepted: 07/02/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The relationship between body mass index (BMI) and the severity of cardioembolic stroke (CES) remains poorly understood. METHOD A total of 419 consecutive CES patients with nonvalvular atrial fibrillation (NVAF), and with a modified Rankin Scale (mRS) score of 0 or 1 before onset admitted within 48hours after onset to the Hirosaki Stroke and Rehabilitation Center were studied. The patients were divided into three groups, low BMI (L-BMI; n = 36, BMI < 18.5 kg/m2), normal BMI (N-BMI; n = 284, 18.5 ≤ BMI < 25.0), and high BMI (H-BMI; n = 99, BMI ≥ 25.0). We compared stroke severity and functional outcome among the three groups. RESULTS Stroke severity on admission, assessed by the National Institutes of Health Stroke Scale (NIHSS) showed that patients with L-BMI had the highest NIHSS score (median, 16 [11-25]), followed by N-BMI and H-BMI (11 [5-19] and 9 [3-19], P = .002). Functional outcome at discharge, assessed by mRS, was most severe in L-BMI patients (5 [3-5]), followed by N-BMI and H-BMI (3 [1-4] and 2 [1-4], P = .001). Multivariate analyses revealed that L-BMI was a significant determinant of severe stroke (NIHSS scores ≥8) at admission (odds ratio [OR] to N-BMI = 2.79, 95% confidence interval [CI], 1.17-7.78, P = .02) and poor functional outcome (mRS scores ≥3) at discharge (OR = 2.53, 95% CI, 1.12-6.31, P = .02). However, H-BMI did not affect stroke severity at admission or functional outcome at discharge. CONCLUSION Low BMI is a risk factor for severe stroke on admission and unfavorable functional outcome at discharge in Japanese CES patients with NVAF.
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Affiliation(s)
- Joji Hagii
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Norifumi Metoki
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Shin Saito
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Ayaka Fujita
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Hiroshi Shiroto
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Satoko Sasaki
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Koki Takahashi
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Hiroyasu Hitomi
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Yoshiko Baba
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Satoshi Seino
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Takaatu Kamada
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | | | - Manabu Iwata
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Shigeo Matsumoto
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Minoru Yasujima
- Hirosaki Stroke and Rehabilitation Center, Hirosaki 036-8104, Japan
| | - Hirofumi Tomita
- Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan; Department of Hypertension and Stroke Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
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