Determining the Joint Effect of Obesity and Diabetes on All-Cause Mortality and Cardiovascular-Related Mortality following an Ischemic Stroke.
Determining the Joint Effect of Obesity and Diabetes on All-Cause Mortality and Cardiovascular-Related Mortality following an Ischemic Stroke.
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DOI：
10.1155/2018/4812712
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发表时间：
2018
影响因子：
1.5
通讯作者：
Ford ME
中科院分区：
文献类型：
--
作者：
Bauza C;Martin R;Yeatts SD;Borg K;Magwood G;Selassie A;Ford ME
虽然肥胖和糖尿病或糖尿病与死亡相关事件（例如，全因死亡率和心血管相关死亡率），但关于肥胖和糖尿病对缺血性卒中后死亡率相关事件的联合作用知之甚少。本研究的目的是评估肥胖和糖尿病对近期缺血性卒中受试者死亡相关事件的联合影响。本研究分析了多中心预防方案有效避免二次卒中（PRoFESS）试验的数据。通过考克斯比例风险回归模型估计肥胖和糖尿病对死亡相关事件的联合效应。糖尿病肥胖受试者和体重不足/正常体重无糖尿病受试者之间缺血性卒中后全因死亡率的风险无差异。相反，与体重不足/正常体重的无糖尿病受试者相比，肥胖的糖尿病受试者在缺血性卒中后心血管相关死亡率的风险增加。此外，有证据表明相互作用的可归因比例以及心血管相关死亡率乘法量表上高度统计学显著性相互作用的证据。在这个缺血性卒中幸存者的临床试验队列中，肥胖和糖尿病协同作用增加了心血管相关死亡率的危险。
Although obesity and diabetes mellitus, or diabetes, are independently associated with mortality-related events (e.g., all-cause mortality and cardiovascular-related mortality) following an ischemic stroke, little is known about the joint effect of obesity and diabetes on mortality-related events following an ischemic stroke. The aim of this study is to evaluate the joint effect of obesity and diabetes on mortality-related events in subjects with a recent ischemic stroke. Data from the multicenter Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial was analyzed for this study. The joint effect of obesity and diabetes on mortality-related events was estimated via Cox proportional hazards regression models. No difference in the hazard of all-cause mortality following an ischemic stroke was observed between obese subjects with diabetes and underweight/normal-weight subjects without diabetes. In contrast, obese subjects with diabetes had an increased hazard of cardiovascular-related mortality following an ischemic stroke compared with underweight/normal-weight subjects without diabetes. Additionally, there was evidence of an attributable proportion due to interaction as well as evidence of a highly statistically significant interaction on the multiplicative scale for cardiovascular-related mortality. In this clinical trial cohort of ischemic stroke survivors, obesity and diabetes synergistically interacted to increase the hazard of cardiovascular-related mortality.