Determining the joint effect of obesity and diabetes on functional disability at 3-months and on all-cause mortality at 1-year following an ischemic stroke
| Autor: | Sharon D. Yeatts, Marvella E. Ford, Gayenell S. Magwood, Anbesaw W. Selassie, Colleen E. Bauza, Renee H Martin, Keith T. Borg |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Joint effect Functional disability Endocrinology Diabetes and Metabolism 030204 cardiovascular system & hematology lcsh:Diseases of the endocrine glands. Clinical endocrinology Odds Diabetes Complications 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Odds Ratio Humans Medicine Obesity Stroke Aged Clinical Trials as Topic lcsh:RC648-665 business.industry Hazard ratio Diabetes Stroke Rehabilitation General Medicine Odds ratio Middle Aged medicine.disease All-cause mortality Clinical trial Cohort Female business 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Endocrine Disorders, Vol 18, Iss 1, Pp 1-9 (2018) BMC Endocrine Disorders |
| ISSN: | 1472-6823 |
| Popis: | Background Obesity and diabetes mellitus, or diabetes, are independently associated with post-ischemic stroke outcomes (e.g., functional disability and all-cause mortality). Although obesity and diabetes are also associated with post-ischemic stroke outcomes, the joint effect of obesity and diabetes on these post-ischemic stroke outcomes has not been explored previously. The purpose of the current study was to explore whether the effect of obesity on post-ischemic stroke outcomes differed by diabetes status in a cohort of acute ischemic stroke subjects with at least a moderate stroke severity. Methods Data from the Interventional Management of Stroke (IMS) III clinical trial was analyzed for this post-hoc analysis. A total of 656 subjects were enrolled in IMS III and were followed for one year. The joint effects of obesity and diabetes on functional disability at 3-months and all-cause mortality at 1-year were examined. Results Of 645 subjects with complete obesity and diabetes information, few were obese (25.74%) or had diabetes (22.64%). Obese subjects with diabetes and non-obese subjects without diabetes had similar odds of functional disability at 3-months following an ischemic stroke (adjusted common odds ratio, 1.038, 95% CI: 0.631, 1.706). For all-cause mortality at 1-year following an ischemic stroke, obese subjects with diabetes had a similar hazard compared with non-obese subjects without diabetes (adjusted hazard ratio, 1.005, 95% CI: 0.559, 1.808). There was insufficient evidence to declare a joint effect between obesity and diabetes on either the multiplicative scale or the additive scale for both outcomes. Conclusions In this post-hoc analysis of data from the IMS III clinical trial of acute ischemic stroke patients with at least a moderate stroke severity, there was not sufficient evidence to determine that the effect of obesity differed by diabetes status on post-ischemic stroke outcomes. Additionally, there was not sufficient evidence to determine that either factor was independently associated with all-cause mortality. Future studies could differentiate between metabolically healthy and metabolically unhealthy patients within BMI categories to determine if the effect of obesity on post-stroke outcomes differs by diabetes status. |
| Databáze: | OpenAIRE |
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