Measurement of Nutritional Status Using Body Mass Index, Waist-to-Hip Ratio, and Waist Circumference to Predict Treatment Outcome in Females and Males with Acute First-Ever Ischemic Stroke
Measurement of Nutritional Status Using Body Mass Index, Waist-to-Hip Ratio, and Waist Circumference to Predict Treatment Outcome in Females and Males with Acute First-Ever Ischemic Stroke
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DOI：
10.1016/j.jstrokecerebrovasdis.2017.08.016
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发表时间：
2018-01-01
影响因子：
2.5
通讯作者：
Czlonkowska, Anna
中科院分区：
文献类型：
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作者：
Bembenek, Jan Pawel;Karlinski, Michal;Czlonkowska, Anna
背景：我们的目的是调查增加的腰臀比(WHR)、腰围(WC)或不适当的体重指数(BMI)是否可以不同地预测女性和男性首次急性缺血性中风的短期预后。方法：这是一项对2003至2015年间连续入院的首次缺血性卒中患者(1109名女性和939名男性)的回顾性研究。数据是在详细的医院中风登记中收集的。以体重指数(BMI)18.5~24.9 kg/m(2)和不同性别的体重指数(WHC)和腰围(WC)正常值作为比较参考。使用Logistic回归计算住院死亡、死亡或出院时死亡或依赖的几率，并根据患者的年龄和卒中前残疾进行调整。结果：在男女中，高腰围比增加了出院时死亡或依赖的几率(优势比[OR]，1.8；95%可信区间[CI]，女性为1.053.08，男性为1.43；95%CI，男性为1.00-2.04)，但不只是住院死亡。仅在女性中，WC增加与死亡或死亡和出院时依赖的几率降低显著相关(OR，分别为.36；95%CI，.22-.58和.69；95%CI，.48-.97)。BMI在两种性别中都没有显示出任何明确的预测价值。结论：我们的发现表明，用腰围测量超重是女性良好结局的强烈预测因素，但在男性中不是。WHR预测卒中结果的一致性较差，因为它与出院时的死亡无关；然而，WHR似乎在男女患者中具有相似的临床相关性。BMI似乎在预测男女卒中结果方面的临床价值最低。
Background: We aimed to investigate whether increased waist-to-hip ratio (WHR), waist circumference (WC), or improper body mass index (BMI) may differently predict short-term outcomes in females and males with first-ever acute ischemic stroke. Methods: This was a retrospective study of consecutive patients (1109 females and 939 males) admitted for first-ever ischemic stroke between 2003 and 2015. Data were collected in a detailed hospital stroke registry. BMI of 18.5-24.9 kg/m(2) and gender-specific normal values of WHC and WC were used as references for comparisons. Logistic regression was used to calculate the odds of in-hospital death or being dead or dependent at discharge, adjusted for patients' age and prestroke disability. Results: In both sexes a high WHR increased the odds of death or dependency at discharge (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.053.08 for females and 1.43; 95% CI, 1.00-2.04 for males), but not in-hospital death alone. Increased WC was significantly associated with lower odds of either death or death and dependency at discharge in females only (OR, .36; 95% CI, .22-.58 and .69; 95% CI, .48-.97, respectively). BMI did not show any clear predictive value in either sex. Conclusions: Our findings suggest that being overweight measured with WC is a strong predictor of good outcome in women but not in men. The WHR less consistently predicts stroke outcome, as it is not associated with death at discharge alone; however, the WHR seems to be of similar clinical relevance in both genders. BMI seems to have the least clinical value in predicting stroke outcome in both genders.