Central adiposity and mortality after first-ever acute ischemic stroke
| Autor: | Sonia Roman, Carolina León-Jiménez, Luis Manuel Murillo-Bonilla, Carlos Cantú-Brito, Alma Ramos, José Luis Ruiz-Sandoval, Erika Martinez-Lopez, Bertha Ruiz-Madrigal, Erwin Chiquete, Arturo Panduro |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Kaplan-Meier Estimate Overweight Body Mass Index Classification of obesity Risk Factors Internal medicine medicine Humans Obesity Stroke Adiposity Proportional Hazards Models Waist-to-height ratio Body volume index business.industry nutritional and metabolic diseases Middle Aged medicine.disease Body Height Neurology Cardiology Central Adiposity Female Neurology (clinical) medicine.symptom Waist Circumference business Body mass index Obesity paradox |
| Zdroj: | European neurology. 70(1-2) |
| ISSN: | 1421-9913 |
| Popis: | Background: The waist-to-height ratio (WHtR) may be a better adiposity measure than the body mass index (BMI). We evaluated the prognostic performance of WHtR in patients with acute ischemic stroke (AIS). Methods: First, we compared WHtR and BMI as adiposity measures in 712 healthy adults by tetrapolar bioimpedance analysis. Thereafter, baseline WHtR was analyzed as predictor of 12-month all-cause mortality in 821 Mexican mestizo adults with first-ever AIS by a Cox proportional hazards model adjusted for baseline predictors. Results: In healthy individuals, WHtR correlated higher than BMI with total fat mass and showed a higher accuracy in identifying a high percentage of body fat (p < 0.01). In AIS patients a U-shaped relationship was observed between baseline WHtR and mortality (fatality rate 29.1%). On multivariate analysis, baseline WHtR ≤0.300 or >0.800 independently predicted 12-month all-cause mortality (hazard ratio 1.91, 95% confidence interval 1.04-3.51). BMI was not associated with mortality, tested either as continuous, binomial or stratified variable. Conclusion: WHtR is a modifiable risk factor that accurately demonstrates body fat excess. Extreme WHtR values were associated with increased 12-month all-cause mortality in Mexican mestizo patients with AIS. No survival advantage was found with high WHtR as the pragmatic indicator of obesity in this population. |
| Databáze: | OpenAIRE |
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