Association between abdominal adiposity and clinical outcomes in patients with acute ischemic stroke.

Autor: Wakisaka K; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Department of Neurology, Steel Memorial Yawata Hospital, Kitakyushu, Japan., Matsuo R; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Irie F; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Wakisaka Y; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Ago T; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Kamouchi M; Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Kitazono T; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jan 11; Vol. 19 (1), pp. e0296833. Date of Electronic Publication: 2024 Jan 11 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0296833
Abstrakt: Background: It is unclear whether abdominal adiposity has an additional effect on post-stroke outcomes. This study aimed to determine whether waist circumference (WC) is independently associated with clinical outcomes after acute ischemic stroke.
Methods: We enrolled patients with acute ischemic stroke from a multicenter hospital-based stroke registry in Fukuoka, Japan. We measured WC on admission and categorized patients into four groups (Q1-Q4) according to the quartiles in females and males. The clinical outcomes were poor functional outcome (modified Rankin scale score 2-6) and death from any cause. Logistic regression analysis was performed to estimate the odds ratio and 95% confidence interval of the outcomes of interest after adjusting for potential confounding factors, including body mass index (BMI).
Results: A total of 11,989 patients (70.3±12.2 years, females: 36.1%) were included in the analysis. The risk of poor functional outcome significantly decreased for Q2-Q4 (vs. Q1) at discharge and Q2-Q3 (vs. Q1) at 3 months, even after adjusting for potential confounders, including BMI. In contrast, adjustment of BMI eliminated the significant association between WC and all-cause death at discharge and 3 months. The association between high WC and favorable functional outcome was not affected by fasting insulin levels or homeostatic model assessment for insulin resistance and was only found in patients without diabetes (P = 0.02 for heterogeneity).
Conclusions: These findings suggest that abdominal adiposity has an additional impact on post-stroke functional outcome, independent of body weight and insulin action.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Wakisaka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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