Moderate-to-vigorous physical activity and the risk of stroke recurrence in patients with a history of minor ischemic stroke in Japan: a retrospective analysis
Moderate-to-vigorous physical activity and the risk of stroke recurrence in patients with a history of minor ischemic stroke in Japan: a retrospective analysis
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DOI：
10.1080/10749357.2018.1507309
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发表时间：
2019-11-17
影响因子：
2.2
通讯作者：
Fujita, Kimie
中科院分区：
文献类型：
--
作者：
Ushio, Miyuki;Kanaoka, Maki;Fujita, Kimie
背景：体力活动（PA）有利于预防脑卒中；特别是中度到剧烈的身体活动（MVPA）。然而，很少有研究探讨其与复发性缺血性卒中（RIS）的关系。目的：阐明首次缺血性脑卒中后MVPA和RIS与危险因素负担之间的关系。方法：在2016年3月至6月期间，在日本一家医院共有45名门诊患者（平均年龄67.1 +/- 10.2岁），他们之前经历过短暂性脑缺血发作或轻微的非心脏栓塞性脑卒中（平均6.4 +/- 4.2岁）。所有患者在臀部佩戴加速度计10天，并通过生物电阻抗测量他们的体脂百分比（%BF）和内脏脂肪水平（VFL）。从临床记录中提取RIS病史和危险因素（血压、脂蛋白胆固醇和估计的肾小球滤过率）的回顾性信息。使用二元logistic回归模型来估计RIS病史与MVPA和潜在危险因素（如社会人口统计学和临床变量（肥胖、吸烟和高血压））的相关性。结果：9例患者发生RIS；VFL （p = 0.007）和%BF （p = 0.007）值明显高于无复发患者，MVPA （p = 0.011）值明显低于无复发患者。这些因素的多因素分析表明，年龄、VFL和MVPA是显著的。不能独立预测RIS。结论：轻度缺血性脑卒中患者MVPA低，VFL值高，两者可能是RIS的危险因素。
Background: Physical activity (PA) is beneficial for stroke prevention; in particular, moderate-to-vigorous physical activity (MVPA). However, few studies have investigated its relationship with recurrent ischemic stroke (RIS). Objectives: To clarify the relationship between MVPA and RIS and the burden of risk factors after a first-ever ischemic stroke. Methods: A total of 45 outpatients (mean age 67.1 +/- 10.2 years) who had previously experienced a transient ischemic attack or a minor non-cardioembolic ischemic stroke at a single hospital in Japan (mean 6.4 +/- 4.2 years previously), were enrolled between March and June 2016. All patients wore an accelerometer around their hips for 10 days, and their percentage body fat (%BF) and visceral fat level (VFL) were measured by bioelectrical impedance. Retrospective information about the history of RIS and risk factors (blood pressure, lipoprotein cholesterol and estimated glomerular filtration rate) were extracted from the clinical records. Binary logistic regression models were used to estimate the relevance of the RIS history to MVPA and potential risk factors such as sociodemographic and clinical variables (obesity, smoking and hypertension). Results: RIS occurred in 9 patients; they had significantly higher VFL (p = 0.007) and %BF (p = 0.007) values and lower MVPA (p = 0.011) values than patients without recurrence. A multivariate analysis of these factors indicated that age, VFL and MVPA were signi?cant independent predictors of RIS. Conclusions: Patients with a history of mild ischemic stroke had low MVPA and high VFL values, which together may be a risk factor for RIS.