Association of Body Mass Index and Risk of Stroke After Acute Minor Stroke or TIA: a Post Hoc Analysis of a Randomized Controlled Trial
Association of Body Mass Index and Risk of Stroke After Acute Minor Stroke or TIA: a Post Hoc Analysis of a Randomized Controlled Trial
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体重指数与急性轻微中风或 TIA 后中风风险的关联：随机对照试验的事后分析
DOI：
10.1007/s12640-019-00056-4
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发表时间：
2019-11-01
影响因子：
3.7
通讯作者：
Wang, Yongjun
中科院分区：
文献类型：
--
作者：
Chen, Weiqi;Pan, Yuesong;Wang, Yongjun
在中风患者中报告了“肥胖悖论”。我们的目的是评估轻微缺血性卒中或短暂性脑缺血发作（TIA）患者的体重指数（BMI）与卒中预后之间的关系模式和程度。共纳入了5163例具有氯吡格雷治疗急性非致残性脑血管事件高危患者（CHANCE）试验中可用BMI数据的患者。根据BMI值将患者分为三组：正常体重（< 23.9 kg/m2）、超重（24-27.9 kg/m2）和肥胖（>= 28.0 kg/m2）。疗效结局包括新发卒中（缺血性或出血性）、功能不良结局（定义为改良兰金量表≥ 2分）和90天内任何原因导致的死亡。使用多变量考克斯或逻辑回归模型确定相互作用效应。在90天的随访中，有513例新发中风。校正基线协变量后，超重（BMI 24-27.9 kg/m2）患者复发卒中的风险高于正常体重患者（10.8% vs 8.8%; HR = 1.24，95% CI 1.02-1.50），但未观察到肥胖患者与卒中复发的显著相关性（P = 0.37）。超重或肥胖与不良功能结局或死亡之间无显著相关性。在我们的研究中，对于轻度缺血性卒中或TIA患者，与正常体重相比，超重与卒中复发风险增加相关。
The "obesity paradox" was reported in patients with stroke. We aimed to evaluate the pattern and magnitude of association between body mass index (BMI) and prognosis of stroke in patients with minor ischemic stroke or transient ischemic attack (TIA). A total of 5163 patients with available BMI data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial were included. Patients were classified into three groups according to their BMI values: normal weight (< 23.9 kg/m(2)), overweight (24-27.9 kg/m(2)), and obese (>= 28.0 kg/m(2)). The efficacy outcomes included a new stroke (ischemic or hemorrhagic), poor functional outcome defined as modified Rankin scale >= 2 points and death from any cause within 90 days. The interaction effects were determined using multivariable Cox or logistic regression models. After 90 days of follow up, there were 513 new strokes. Overweight (BMI 24-27.9 kg/m(2)) patients had a higher risk of recurrent strokes than those with normal weight (10.8% vs 8.8%; HR = 1.24, 95% CI 1.02-1.50) after adjusting for the baseline covariates, but no significant association was observed for those who were obese (P = 0.37). No significant association was found between being overweight or obese and poor functional outcome or death. For patients with a minor ischemic stroke or TIA, being overweight was associated with an increased risk of recurrent stroke compared to being of normal weight in our study.