scholarly journals Effect of the Interaction between Depression and Sleep Disorders on the Stroke Occurrence: An Analysis Based on National Health and Nutritional Examination Survey

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jia Li ◽  
Leijun Li ◽  
Yan Lv ◽  
Yanhai Kang ◽  
Mingjin Zhu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Sleep Disorders ◽  
National Health ◽  
Univariate Analysis ◽  
Depression Severity ◽  
Stroke Patients ◽  
Additive Interaction ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Nutritional Examination Survey

Objective. To investigate the effect of the interaction between depression and sleep disorders on the stroke occurrence based on the data from the National Health and Nutritional Examination Survey (NHANES). Methods. Seven cycles of 2-year NHANES data (2005-2018) were analyzed in this study. Univariate analysis was first performed between the stroke and nonstroke patients, and then, multivariate logistic regression models were conducted to analyze the association of depression, sleep disorders, and their interactions with stroke occurrence. Results. A total of 30473 eligible participants were included in this study, including 1138 (3.73%) with stroke and 29335 (96.27%) with nonstroke. Except sex, the differences were all significant between the stroke and nonstroke patients in baseline information (all P < 0.001 ). Depression (odds ratio (OR): 2.494, 95% confidence interval (CI): 2.098-2.964), depression severity (moderate, OR: 2.013, 95% CI: 1.612-2.514; moderately severe, OR: 2.598, 95% CI: 1.930-3.496; severe, OR: 5.588, 95% CI: 3.883-8.043), and sleep disorders (OR: 1.677, 95% CI: 1.472-1.910) were presented to be associated with an increased risk of stroke after correcting all the confounders. The logistic regression analysis showed that there was a synergic, additive interaction between depression and sleep disorders on the stroke occurrence, and the proportion of stroke patients caused by this interaction accounted for 27.1% of all the stroke patients. Conclusion. Depression, depression severity, and sleep disorders are all independently associated with a high risk of stroke. The interaction between depression and sleep disorders can synergistically increase the stroke occurrence.

scholarly journals OP0034 DOES THE RISK OF VENOUS THROMBOEMBOLISM VARY WITH DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 23.2-24
Author(s):  
V. Molander ◽  
H. Bower ◽  
J. Askling
Keyword(s):  
Rheumatoid Arthritis ◽  
Logistic Regression ◽  
Venous Thromboembolism ◽  
Disease Activity ◽  
Das28 Score ◽  
Logistic Regression Models ◽  
Highly Active ◽  
Increased Risk ◽  
Das28 Remission ◽  
One Year

Background:Patients with rheumatoid arthritis (RA) are at increased risk for venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) (1). Several established risk factors of VTE, such as age, immobilization and comorbid conditions, occur more often patients with RA (2). In addition, inflammation may in itself also increase VTE risk by upregulating procoagolatory factors and causing endothelial damage (3). Recent reports indicate an increased risk of VTE in RA patients treated with JAK-inhibitors (4), pointing to the need to better understand how inflammation measured as clinical RA disease activity influences VTE risk.Objectives:To investigate the relationship between clinical RA disease activity and incidence of VTE.Methods:Patients with RA were identified from the Swedish Rheumatology Quality Register (SRQ) between July 1st2006 and December 31st2017. Clinical rheumatology data for these patients were obtained from the visits recorded in SRQ, and linked to national registers capturing data on VTE events and comorbid conditions. For each such rheumatologist visit, we defined a one-year period after the visit and determined whether a VTE event had occurred within this period or not. A visit followed by a VTE event was categorized as a case, all other visits were used as controls. Each patient could contribute to several visits. The DAS28 score registered at the visit was stratified into remission (0-2.5) vs. low (2.6-3.1), moderate (3.2-5.1) and high (>5.1) disease activity. Logistic regression with robust cluster standard errors was used to estimate the association between the DAS28 score and VTE.Results:We identified 46,311 patients with RA who contributed data from 320,094 visits. Among these, 2,257 visits (0.7% of all visits) in 1345 unique individuals were followed by a VTE within the one-year window. Of these, 1391 were DVT events and 866 were PE events. Figure 1 displays the absolute probabilities of a VTE in this one-year window, and odds ratios for VTE by each DAS28 category, using DAS28 remission as reference. The one-year risk of a VTE increased from 0.5% in patients in DAS28 remission, to 1.1% in patients with DAS28 high disease activity (DAS28 above 5.1). The age- and sex-adjusted odds ratio for a VTE event in highly active RA compared to RA in remission was 2.12 (95% CI 1.80-2.47). A different analysis, in which each patient could only contribute to one visit, yielded similar results.Figure 1.Odds ratios (OR) comparing the odds of VTE for DAS28 activity categories versus remission. Grey estimates are from unadjusted logistic regression models, black estimates are from logistic regression models adjusted for age and sex. Absolute one-year risk of VTE are estimated from unadjusted models.Conclusion:This study demonstrates a strong association between clinical RA inflammatory activity as measured through DAS28 and risk of VTE. Among patients with high disease activity one in a hundred will develop a VTE within the coming year. These findings highlight the need for proper VTE risk assessment in patients with active RA, and confirm that patients with highly active RA, such as those recruited to trials for treatment with new drugs, are already at particularly elevated risk of VTE.References:[1]Holmqvist et al. Risk of venous thromboembolism in patients with rheumatoid arthritis and association with disease duration and hospitalization. JAMA. 2012;308(13):1350-6.[2]Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007;44(2):62-9.[3]Xu J et al. Inflammation, innate immunity and blood coagulation. Hamostaseologie. 2010;30(1):5-6, 8-9.[4]FDA. Safety trial finds risk of blood clots in the lungs and death with higher dose of tofacitinib (Xeljanz, Xeljanz XR) in rheumatoid arthritis patients; FDA to investigate. 2019.Acknowledgments:Many thanks to all patients and rheumatologists persistently filling out the SRQ.Disclosure of Interests:Viktor Molander: None declared, Hannah Bower: None declared, Johan Askling Grant/research support from: JA acts or has acted as PI for agreements between Karolinska Institutet and the following entities, mainly in the context of the ARTIS national safety monitoring programme of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB Pharma

Combined Associations of Muscle-Strengthening Activities and Accelerometer-Assessed Physical Activity on Multimorbidity: Findings From NHANES

2016 ◽  
Vol 31 (4) ◽  
pp. 274-277 ◽  
Author(s):  
Scott J. Dankel ◽  
Jeremy P. Loenneke ◽  
Paul D. Loprinzi
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Chronic Disease ◽  
Confidence Interval ◽  
National Health ◽  
Cost Effective ◽  
Muscle Strengthening ◽  
Recommended Guidelines ◽  
Nutritional Examination Survey

Purpose. Physical activity (PA) has previously been demonstrated to be inversely related with multimorbidity (having more than one chronic disease); however, it is unknown whether dual participation in both PA and muscle-strengthening activities (MSA) may further reduce the odds of being multimorbid. Therefore, the purpose of our study was to determine the association between multimorbidity and individuals meeting recommended guidelines for both PA and MSA. Design. Nonexperimental. Setting. The 2003–2006 National Health and Nutritional Examination Survey. Subjects. Four thousand five hundred eighty-seven adults aged ≥20 years. Measures. Accelerometry-measured PA, self-reported MSA, and multimorbidity. Analysis. Data were analyzed using multivariable linear and logistic regression. Results. The odds (95% confidence interval) of being multimorbid for those only meeting MSA guidelines, only meeting PA guidelines, and meeting both PA and MSA guidelines (vs. not meeting either), respectively, were .69 (.48, .98; p = .04), .55 (.44, .70; p < .01), and .38 (.27, .53; p < .01). Conclusion. Our findings demonstrate that individuals meeting recommended guidelines for both MSA and PA were less likely to be multimorbid than individuals participating in one or none of these exercise modalities. Determining effective ways to initiate and maintain concurrent adoption of MSA and PA is needed to provide a cost-effective behavioral alternative for reducing the prevalence of multimorbidity.

scholarly journals Dysphagia in Patients with Acute Ischemic Stroke: Early Dysphagia Screening May Reduce Stroke-Related Pneumonia and Improve Stroke Outcomes

2016 ◽  
Vol 42 (1-2) ◽  
pp. 81-89 ◽  
Author(s):  
Mohamed Al-Khaled ◽  
Christine Matthis ◽  
Andreas Binder ◽  
Jonas Mudter ◽  
Joern Schattschneider ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Case Fatality ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Stroke Outcomes ◽  
Increased Risk ◽  
Reduced Risk

Background: Dysphagia is associated with poor outcome in stroke patients. Studies investigating the association of dysphagia and early dysphagia screening (EDS) with outcomes in patients with acute ischemic stroke (AIS) are rare. The aims of our study are to investigate the association of dysphagia and EDS within 24 h with stroke-related pneumonia and outcomes. Methods: Over a 4.5-year period (starting November 2007), all consecutive AIS patients from 15 hospitals in Schleswig-Holstein, Germany, were prospectively evaluated. The primary outcomes were stroke-related pneumonia during hospitalization, mortality, and disability measured on the modified Rankin Scale ≥2-5, in which 2 indicates an independence/slight disability to 5 severe disability. Results: Of 12,276 patients (mean age 73 ± 13; 49% women), 9,164 patients (74%) underwent dysphagia screening; of these patients, 55, 39, 4.7, and 1.5% of patients had been screened for dysphagia within 3, 3 to <24, 24 to ≤72, and >72 h following admission. Patients who underwent dysphagia screening were likely to be older, more affected on the National Institutes of Health Stroke Scale score, and to have higher rates of neurological symptoms and risk factors than patients who were not screened. A total of 3,083 patients (25.1%; 95% CI 24.4-25.8) had dysphagia. The frequency of dysphagia was higher in patients who had undergone dysphagia screening than in those who had not (30 vs. 11.1%; p < 0.001). During hospitalization (mean 9 days), 1,271 patients (10.2%; 95% CI 9.7-10.8) suffered from stroke-related pneumonia. Patients with dysphagia had a higher rate of pneumonia than those without dysphagia (29.7 vs. 3.7%; p < 0.001). Logistic regression revealed that dysphagia was associated with increased risk of stroke-related pneumonia (OR 3.4; 95% CI 2.8-4.2; p < 0.001), case fatality during hospitalization (OR 2.8; 95% CI 2.1-3.7; p < 0.001) and disability at discharge (OR 2.0; 95% CI 1.6-2.3; p < 0.001). EDS within 24 h of admission appeared to be associated with decreased risk of stroke-related pneumonia (OR 0.68; 95% CI 0.52-0.89; p = 0.006) and disability at discharge (OR 0.60; 95% CI 0.46-0.77; p < 0.001). Furthermore, dysphagia was independently correlated with an increase in mortality (OR 3.2; 95% CI 2.4-4.2; p < 0.001) and disability (OR 2.3; 95% CI 1.8-3.0; p < 0.001) at 3 months after stroke. The rate of 3-month disability was lower in patients who had received EDS (52 vs. 40.7%; p = 0.003), albeit an association in the logistic regression was not found (OR 0.78; 95% CI 0.51-1.2; p = 0.2). Conclusions: Dysphagia exposes stroke patients to a higher risk of pneumonia, disability, and death, whereas an EDS seems to be associated with reduced risk of stroke-related pneumonia and disability.

Prognostic significance of international normalised ratio and prothrombin time in Chinese acute ischaemic stroke patients

2022 ◽  
pp. postgradmedj-2021-141204
Author(s):  
Shoujiang You ◽  
Qiao Han ◽  
Xiaofeng Dong ◽  
Chongke Zhong ◽  
Huaping Du ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischaemic Stroke ◽  
Prothrombin Time ◽  
Hospital Discharge ◽  
Acute Ischaemic Stroke ◽  
Regression Models ◽  
Logistic Regression Models ◽  
Risk Of Death ◽  
Increased Risk ◽  
International Normalised Ratio

BackgroundWe investigated the association between international normalised ratio (INR) and prothrombin time (PT) levels on hospital admission and in-hospital outcomes in acute ischaemic stroke (AIS) patients.MethodsA total of 3175 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. We divided patients into four groups according to their level of admission INR: (<0.92), Q2 (0.92–0.98), Q3 (0.98–1.04) and Q4 (≥1.04) and PT. Logistic regression models were used to estimate the effect of INR and PT on death or major disability (modified Rankin Scale score (mRS)>3), death and major disability (mRS scores 4–5) separately on discharge in AIS patients.ResultsHaving an INR level in the highest quartile (Q4) was associated with an increased risk of death or major disability (OR 1.69; 95% CI 1.23 to 2.31; P-trend=0.001), death (OR, 2.64; 95% CI 1.12 to 6.19; P-trend=0.002) and major disability on discharge (OR, 1.56; 95% CI 1.13 to 2.15; P-trend=0.008) in comparison to Q1 after adjusting for potential covariates. Moreover, in multivariable logistic regression models, having a PT level in the highest quartile also significantly increased the risk of death (OR, 2.38; 95% CI 1.06 to 5.32; P-trend=0.006) but not death or major disability (P-trend=0.240), major disability (P-trend=0.606) on discharge.ConclusionsHigh INR at admission was independently associated with death or major disability, death and major disability at hospital discharge in AIS patients and increased PT was also associated with death at hospital discharge.

Abstract 1122‐000035: Is Age Critical in Determining Stroke Severity Within the Telestroke Network?

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Cassie A Simmons ◽  
Nicolas Poupore ◽  
Fernando Gonzalez ◽  
Thomas I Nathaniel
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Risk Factor ◽  
Univariate Analysis ◽  
Baseline Risk ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Stroke Risk Factor ◽  
Patients Âgés ◽  
Increased Risk

Introduction : Age is the single most important risk factor for stroke and an estimated 75% of all strokes occur in people >65 years of age. In addition, adults >75 years’ experience more hospitalization stays and higher mortality rates with an estimated 50% in the occurrence of all strokes. Several comorbidities have been linked to an increased risk and severity of acute ischemic stroke (AIS). How these factors differentially contribute to the severity of stroke in patients ages >65 and <75 as well as those ≥75 is not known. In this study, we aim to investigate how age, coupled with various clinical risk factors, affects AIS severity within these two age categories. Methods : This retrospective data analysis study was conducted using the data collected from the PRISMA Health Stroke Registry between 2010 and 2016. Baseline clinical and demographic data for patients ages >65 and <75 as well as those ≥75 was analyzed using univariate analysis. Receiver operating characteristic (ROC) curve analysis and multivariate regression models were used to examine the association of specific baseline risk factors or comorbidities associated with worsening or improving neurologic functions. The primary functions were risk factors associated with improving or worsening neurologic outcome in each age category. Results : Adjusted multivariate analysis showed that AIS population of patients >65 and <75 experiencing heart failure (OR = 4.398, 95% CI, 3.912 – 494.613, P = 0.002) and elevated HDL levels (OR = 1.066, 95% CI, 1.009 – 1.126, P = 0.024) trended towards worsening neurologic functions while patients experiencing obesity (OR = 0.177, 95% CI, 0.041 – 0.760, P = 0.020) exhibited improving neurologic functions. For the patients ≥75 years of age, direct admission (OR = 0.270, 95% CI, 0.085 – 0.856, P = 0.026) was associated with improvement of patients treated in the telestroke. Conclusions : Age is a strong risk factor for AIS, and aged stroke patients have higher morbidity and worsening functional recovery than younger patients. In this study, we observed differences in stroke risk factor profiles for >65 and <75 and ≥75 age categories. Heart failure and elevated HDL levels were significantly associated with worsening neurologic functions among AIS for patients aged >65 and <75. Obese patients and individuals ≥75 years who were directly admitted were most likely to exhibit improving neurologic functions. Most importantly, findings from this study reveal specific risk factors that can be managed to improve the care in older stroke patients treated in the telestroke network.

scholarly journals The association of frontal recess anatomy and mucosal disease on the presence of chronic frontal sinusitis: a computed tomographic analysis

2014 ◽  
Vol 52 (3) ◽  
pp. 208-214
Author(s):  
W.-S. Lai ◽  
P.-L. Yang ◽  
C.-H. Lee ◽  
Y.-Y. Lin ◽  
Y.-H. Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Strong Association ◽  
Ct Scans ◽  
Mucosal Inflammation ◽  
Frontal Sinusitis ◽  
Logistic Regression Models ◽  
Computed Tomographic ◽  
Frontal Recess ◽  
Inflammatory Conditions ◽  
Increased Risk

Objectives: The frontal sinus has the most complex and variable drainage routes of all paranasal sinus regions. The goal of this study was to identify these anatomical factors and inflammation areas relating to chronic frontal sinusitis by comparing radiological presentations in patients with and without frontal sinusitis. Methods: All adult patients with chronic rhinosinusitis who had received computed tomography (CT) scans of the nasal cavities and paranasal sinuses between October 2010 and September 2011. Logistic regression analysis was used to compare the distribution of various frontal recess cells and surrounding inflammatory conditions in patients with and without frontal sinusitis. Results: Analysis of 240 sides of CT scans was performed with 66 sides excluded. The opacification of the frontal recess and sinus lateralis demonstrated a strong association with an increased presence of frontal sinusitis by multiple logistic regression models. Conclusion: Opacification of the frontal recess and sinus lateralis was found to be associated with a significantly increased risk of frontal sinusitis and developing severe blockage of drainage pathways. It provides evidence that mucosal inflammation disease in these two areas is a very important factor leading to chronic frontal sinusitis.

Abstract TP321: Is Weekend Admission Associated With Increased 30-day Stroke Mortality? The Effect of Adjustment Using a Claims-Based Stroke Severity Index

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Cheng-Yang Hsieh ◽  
Sheng-Feng Sung
Keyword(s):  
Logistic Regression ◽  
Regression Models ◽  
Severity Index ◽  
Case Mix ◽  
Stroke Severity ◽  
Stroke Mortality ◽  
Multivariate Logistic Regression ◽  
Stroke Patients ◽  
Logistic Regression Models ◽  
Case Mix Adjustment

Introduction: Whether weekend admission is associated with increased stroke mortality in Taiwan remains uncertain, partly because of an inadequate case-mix adjustment in other studies using an insurance claims databases. Hypothesis: Adding the 7-item claims-based stroke severity index (SSI) to a multivariate logistic regression model might alter the analysis of the effect of weekend admission on 30-day stroke mortality. Methods: We identified, in the Taiwan Longitudinal Health Insurance Database, which is linked with the National Death Registry, patients hospitalized for acute ischemic stroke between 2001 and 2013. The primary outcome was mortality 30 days post-admission. In base logistic regression models with and without the SSI, we tested the odds ratio (OR) of 30-day mortality in patient admitted on weekends using the covariates of age, sex, year of admission, Charlson’s comorbidity index, brain surgery, physician specialty and surgical volume, hospital ownership, accreditation, and patient volume. Results: We analyzed 46,007 consecutive hospitalized stroke patients (mean age: 68.8 ± 12.0 years; male: 59%), with an SSI of 7.5 ± 5.3 (range: 4.1-27.1), 23.0% were admitted on the weekend, and 4.2% died within 30 days. Patients who died within 30 days were more likely to have been admitted on a weekend (4.9% vs. 4.0%, p < 0.001). Nevertheless, patients admitted on a weekend had a higher SSI than those admitted on a weekday (7.8 vs. 7.4, p < 0.001). In multivariate logistic regression models, weekend admission was associated with 30-day mortality (OR: 1.22, 95% CI: 1.10-1.35) in the base model but not in the base model plus SSI (OR: 1.07, 95% CI: 0.95-1.20). Conclusions: We confirmed that, after stroke severity had been adjust by adding the SSI, weekend admission did not increase the 30-day mortality of stroke patients in Taiwan. A case-mix adjustment in comparative outcome studies of stroke patients is important when using an insurance claims database.

scholarly journals The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data for 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003–2006

2019 ◽  
Vol 75 (9) ◽  
pp. 1779-1785 ◽  
Author(s):  
Ekaterina Smirnova ◽  
Andrew Leroux ◽  
Quy Cao ◽  
Lucia Tabacu ◽  
Vadim Zipunnikov ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Regression ◽  
National Health ◽  
Predictive Performance ◽  
Wearable Technology ◽  
Living Environment ◽  
Activity Count ◽  
All Cause Mortality ◽  
Nutritional Examination Survey

Abstract Background Declining physical activity (PA) is a hallmark of aging. Wearable technology provides reliable measures of the frequency, duration, intensity, and timing of PA. Accelerometry-derived measures of PA are compared with established predictors of 5-year all-cause mortality in older adults in terms of individual, relative, and combined predictive performance. Methods Participants aged between 50 and 85 years from the 2003–2006 National Health and Nutritional Examination Survey (NHANES, n = 2,978) wore a hip-worn accelerometer in the free-living environment for up to 7 days. A total of 33 predictors of 5-year all-cause mortality (number of events = 297), including 20 measures of objective PA, were compared using univariate and multivariate logistic regression. Results In univariate logistic regression, the total activity count was the best predictor of 5-year mortality (Area under the Curve (AUC) = 0.771) followed by age (AUC = 0.758). Overall, 9 of the top 10 predictors were objective PA measures (AUC from 0.771 to 0.692). In multivariate regression, the 10-fold cross-validated AUC was 0.798 for the model without objective PA variables (9 predictors) and 0.838 for the forward selection model with objective PA variables (13 predictors). The Net Reclassification Index was substantially improved by adding objective PA variables (p &lt; .001). Conclusions Objective accelerometry-derived PA measures outperform traditional predictors of 5-year mortality, including age. This highlights the importance of wearable technology for providing reproducible, unbiased, and prognostic biomarkers of health.

Development of an Algorithm for Stroke Prediction: A National Health Insurance Database Study in Korea

2018 ◽  
Vol 79 (3-4) ◽  
pp. 214-220 ◽  
Author(s):  
Seung Nam Min ◽  
Se Jin Park ◽  
Dong Joon Kim ◽  
Murali Subramaniyam ◽  
Kyung-Sun Lee
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Stroke Prevention ◽  
Normal Subjects ◽  
Control Group ◽  
Modifiable Risk Factors ◽  
Stroke Patients

Background: Stroke is the second leading cause of death worldwide and remains an important health burden both for the individuals and for the national healthcare systems. Potentially modifiable risk factors for stroke include hypertension, cardiac disease, diabetes, and dysregulation of glucose metabolism, atrial fibrillation, and lifestyle factors. Objects: We aimed to derive a model equation for developing a stroke pre-diagnosis algorithm with the potentially modifiable risk factors. Methods: We used logistic regression for model derivation, together with data from the database of the Korea National Health Insurance Service (NHIS). We reviewed the NHIS records of 500,000 enrollees. For the regression analysis, data regarding 367 stroke patients were selected. The control group consisted of 500 patients followed up for 2 consecutive years and with no history of stroke. Results: We developed a logistic regression model based on information regarding several well-known modifiable risk factors. The developed model could correctly discriminate between normal subjects and stroke patients in 65% of cases. Conclusion: The model developed in the present study can be applied in the clinical setting to estimate the probability of stroke in a year and thus improve the stroke prevention strategies in high-risk patients. The approach used to develop the stroke prevention algorithm can be applied for developing similar models for the pre-diagnosis of other diseases.

scholarly journals Sex Differences in the Association Between Food Insecurity and Obesity Among College Students

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 181-181
Author(s):  
Aseel El Zein ◽  
Karla Shelnutt ◽  
Sarah Colby ◽  
Geoffrey Greene ◽  
Wenjun Zhou ◽  
...  
Keyword(s):  
College Students ◽  
Logistic Regression ◽  
Food Security ◽  
Food Insecurity ◽  
Cross Sectional Study ◽  
High Food ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Food And Agriculture ◽  
Increased Risk

Abstract Objectives This study aimed to assess the association between food insecurity and obesity and to examine whether it varies by sex. Methods A cross-sectional study was conducted in spring 2017 among college students from eight U.S. institutions. Participants (n = 683) completed the USDA Adult Food Security Survey and had their weight and height measured by researchers. Multivariate logistic regression models were used to estimate the sex-specific associations between food insecurity and obesity (BMI ≥ 30 kg/m2), after adjusting for socioeconomic covariates. Results Overall, 25.4% of students identified as food insecure and 10.5% were obese. The prevalence of obesity increased as the level of food insecurity increased, from 5.2% for those with high food security, 13.4% for those with marginal food security, to 17.4% and 21.6% for students with low and very low food security. In logistic regression analysis, marginal, low and very low food security students had an odds ratio of 2.83 (95% CI: 1.43, 5.57), 3.86 (95% CI: 1.88, 7.91), and 5.05 (95% CI:, 2.44, 10.48) of obesity compared to students with high food security, exhibiting a dose-response relationship. Among females, having marginal (OR = 4.21, 95% CI: 1.70, 9.75), low (OR = 4.51, 95% CI: 1.40, 12.47), or very low food security (OR = 7.08, 95% CI: 2.60, 18.41) predicted higher odds of obesity compared to female students with high food security. Among males, those with low food security had higher odds of obesity (OR = 6.40, 95% CI: 1.78, 20.7). Conclusions The association between food insecurity and obesity in U.S. college students remained after adjustment for multiple socio-economic factors. Overall, food insecure females experienced an increase in the risk of obesity as food insecurity increased; however, only males with low food security had an increased risk of obesity. Programs directed toward obesity prevention need to address any level of food insecurity as a risk factor in females, and target males with low food security. Although beyond the scope of this study, it is possible that programs to reduce food insecurity may help prevent obesity in college students. Funding Sources This material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2014–67,001-21,851.

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