Abstract P72: The Obesity Paradox: Association Between Body Mass Index (BMI) and Disability After Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Brianna R Helms
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Functional Status ◽  
Hospital Discharge ◽  
Body Mass ◽  
Obesity Paradox ◽  
Normal Weight ◽  
Stroke Recurrence ◽  
Inverse Association ◽  
Stroke Patients

Background: Present rise in the incidence of obesity has led to several opposing reports regarding the association between obesity and stroke outcomes. The objective of this study was to investigate a proposed paradoxical relationship between body mass index (BMI) and functional status in ischemic stroke patients at time of hospital discharge. Methods: Saint Francis Hospital Comprehensive Stroke Center patient databases were utilized in identifying 948 patients eligible for retrospective chart review over a period of 15 months. Subjects were divided into 4 groups according to BMI: underweight (BMI < 18.5 kg/m 2 ), normal weight (BMI 18.5-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), and obese (BMI ≥ 30.0 kg/m 2 ). Covariates, such as age, gender, prior to event modified Rankin scale (mRS), stroke recurrence, and smoking, were considered. Functional status and disability of stroke patients was scored via mRS at hospital discharge. Ordered logistic regression, Pearson’s chi-squared test, and Pearson’s r correlation were used for analysis to assess the association of BMI and functional status in ischemic strokes. Results: Of 948 eligible subjects, 49.9% were female and mean (SD) age was 69.4 (14.5) years. According to BMI, 22 (2.3%) were underweight, 247 (26.1%) normal weight, 319 (33.7%) overweight, and 360 (37.9%) obese. After adjusting for covariates, ischemic stroke patients with an increased BMI (OR, 0.98; 95% CI, 0.96-0.99) were not associated with increased disability risk upon discharge. Obese (16.2%) and overweight (14.1%) patients discharged with a mRS of 0 (back to baseline) or 1 more frequently compared to normal weight (6.1%) and underweight (0.21%) patients ( P <0.001). Furthermore, an inverse association between BMI status and disability was significantly evident ( r = -0.17, P < 0.001). Conclusion: Obese and overweight stroke patients discharge with a lower risk of disability than normal weight and underweight patients, supporting the existence of the “obesity paradox” in stroke. An inverse association between obesity status and functional outcome was identified and remained significant regardless of covariates.

scholarly journals An Analysis of the Potential Relationship of Triglyceride Glucose and Body Mass Index With Stroke Prognosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Zongyi Hou ◽  
Yuesong Pan ◽  
Yindong Yang ◽  
Xiaofan Yang ◽  
Xianglong Xiang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Normal Weight ◽  
Inverse Association ◽  
Stroke Outcome ◽  
Obese Patients ◽  
Stroke Patients ◽  
Tyg Index ◽  
All Cause Mortality

Background: The inverse association between obesity and outcome in stroke patients (known as the obesity paradox) has been widely reported, yet mechanistic details explaining the paradox are limited. The triglyceride glucose (TYG) index has been proposed as a marker of insulin resistance. We sought to explore possible associations of the TYG index, body mass index (BMI), and stroke outcome.Methods: We identified 12,964 ischemic stroke patients without a history of diabetes mellitus from the China National Stroke Registry and classified patients as either low/normal weight, defined as a BMI &lt;25 kg/m2, or overweight/obese, defined as a BMI ≥ 25 kg/m2. We calculated TYG index and based on which the patients were divided into four groups. A Cox or logistic regression model was used to evaluate the association between BMI and TYG index and its influence on stroke outcomes, including stroke recurrence all-cause mortality and poor outcome (modified Rankin Scale score of 3–6) at 12 months.Results: Among the patients, 63.3% were male, and 36.7% were female, and the mean age of the patient cohort was 64.8 years old. The median TYG index was 8.62 (interquartile range, 8.25–9.05). After adjusting for multiple potential covariates, the all-cause mortality of overweight/obese patients was significantly lower than that of the low/normal weight patients (6.17 vs. 9.32%; adjusted hazard ratio, 0.847; 95% CI 0.732–0.981). The difference in mortality in overweight/obese and low/normal weight patients with ischemic stroke was not associated with TYG index, and no association between BMI and TYG index was found.Conclusion: Overweight/obese patients with ischemic stroke have better survival than patients with low/normal weight. The association of BMI and stroke outcome is not changed by TYG index.

The Impact of Body Mass Index on the Thrombolytic Treatment of Acute Ischemic Stroke

2016 ◽  
Vol 42 (3-4) ◽  
pp. 240-246 ◽  
Author(s):  
Anastasios Chatzikonstantinou ◽  
Anne D. Ebert ◽  
Marc E. Wolf
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Volume ◽  
Body Mass ◽  
Intravenous Thrombolysis ◽  
Normal Weight ◽  
Thrombolytic Treatment ◽  
Stroke Patients

Background: Body weight and body mass index (BMI) are regularly assessed factors in stroke patients for manifold reasons. However, their potential role specifically in intravenous thrombolysis has not been thoroughly examined. Methods: Data from 865 consecutive acute ischemic stroke patients treated with intravenous thrombolysis were analyzed. Patients were divided into different BMI categories (underweight, normal weight, overweight, obese) and compared based on the following factors: time window of treatment, clinical scores National Institute of Health Stroke Scale Score (NIHSS), modified Rankin scale (mRS) on admission and discharge, risk factors, stroke characteristics and thrombolysis complications. Recombinant tissue plasminogen activator (rtPA) doses relative to body weight and blood volume were also assessed. In a separate analysis, patients weighing up to 100 and >100 kg were compared. Results: Eighteen patients (2.1%) were underweight, 336 (38.8%) overweight, 194 (22.4%) obese and 317 (36.7%) had normal weight. Higher BMI category was associated with younger age, thrombolytic treatment later than 4.5 h, arterial hypertension, diabetes and higher relative rtPA dose relative to blood volume (p < 0.001). There were no significant differences concerning NIHSS and mRS scores or thrombolysis complications. Forty-six patients (5.3%) weighed over 100 kg. They were younger (p = 0.002) and treated later than patients under 100 kg (p < 0.001). Mean rtPA dose relative to body weight and to blood volume was significantly lower (0.7 vs. 0.9 mg/kg, p < 0.001 and 13 vs. 13.9 mg/l, p < 0.001). There was a marginal difference in NIHSS score improvement ≥4 points (26.1 vs. 40.2%, p = 0.038); otherwise, no outcome differences were found. Conclusion: BMI category does not significantly influence clinical outcome after thrombolysis. However, relevant NIHSS improvement was found more often in patients weighing up to 100 kg compared to those over 100 kg. Interestingly, patients with higher BMI or weight >100 kg were thrombolysed later than other patients.

scholarly journals Nutrition Literacy among Adolescents and Its Association with Eating Habits and BMI in Tripoli, Lebanon

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 25
Author(s):  
Sara Taleb ◽  
Leila Itani
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Food Habits ◽  
Eating Habits ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Assessment Instrument ◽  
Inverse Association ◽  
Unhealthy Lifestyle ◽  
Cross Sectional

(1) Background: Adolescence is a period of increased autonomy and independent decision making; it determines health behaviors that can persist into the future. Individual factors like food choices and unhealthy lifestyle have an essential role in the development and prevention of obesity among adolescents and are associated with the nutrition literacy of parents and other adults. While the association of parents’ nutrition literacy with adolescent BMI has been addressed, there is still a scarcity of studies that examine the effect of adolescents’ nutrition literacy on their eating habits and body mass index (BMI) status. (2) Methods: A cross-sectional study was conducted that included 189 adolescents (68 with overweight and obesity and 121 with normal weight) aged between 14–19 years from four private schools in Tripoli, Lebanon. A self-administered questionnaire that included the Nutrition Literacy Assessment Instrument (NLAI) and the Adolescent Food Habits Checklist (AFHC) was used. Anthropometrics were measured using standardized procedures. The association between nutrition literacy, food habits and BMI was assessed using a chi squared test for independence and Poisson regression analysis where suitable. (3) Results: Results indicated no association between all five components of nutrition literacy and body mass index categories. Furthermore, there was no association between the Adolescent Food Habits Checklist and overweight or obese BMI status (RR = 0.947, 95%CI: 0.629–1.426) (p = 0.796). No association was observed between nutrition literacy and food habits, except for an inverse association with macronutrients literacy. (4) Conclusions: In conclusion, the study indicated that there was no association between the components of nutrition literacy with body mass index or with food habits, except for macronutrient literacy.

Abstract WP25: The Impact of Body Mass Index on Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Stephanie Chen ◽  
David McCarthy ◽  
Vasu Saini ◽  
Marie Brunet ◽  
Eric Peterson ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Body Mass ◽  
Linear Correlation ◽  
Mechanical Thrombectomy ◽  
Functional Independence ◽  
Normal Weight ◽  
Vessel Occlusion ◽  
The Impact

Background: Obesity is an established risk factor for acute ischemic stroke (AIS), but its impact on clinical outcomes and mortality after AIS remains controversial. In this study, we evaluate the association of body mass index (BMI) on outcomes after mechanical thrombectomy (MT) for large vessel occlusion acute ischemic stroke (LVOS). Methods: We reviewed our prospective MT database for LVOS between 2015 and 2018. BMI was analyzed as a continuous and categorical variable with underweight BMI <18.5, normal BMI 18.5-24.9, overweight BMI 25-29.9, and obese BMI>30. Multivariate analysis was used to determine predictors of outcome. Results: 335 patients underwent MT with 7 (2.1%) patients classified as underweight, 107 (31.9%) normal, 141 (42.1%) overweight, and 80 (23.9%) obese. Compared to normal weight (reference), obese patients had higher rates of hypertension and hyperlipidemia, while underweight patients had higher rates of previous stroke and presentation NIHSS. The time from symptom onset to puncture, procedural techniques, and reperfusion success (>TICI 2b) was not significantly different between BMI categories. There was a significant inverse linear correlation between BMI and symptomatic hemorrhagic. In patients with successful reperfusion (>TICI 2b), there was also a significant bell-shaped relationship between BMI and functional independence (mRS < 3) with both low and high BMIs associated with worse outcomes. In patients without post-procedural symptomatic hemorrhage, there was a significant linear correlation between BMI and inpatient mortality. Conclusion: In LVOS patients treated with MT, BMI is inversely related with post-procedural symptomatic hemorrhage. Yet in those whom reperfusion is achieved, both lower and higher than normal BMI were associated with worse functional outcomes. Thus, the obesity paradox does not appear to pertain to mechanical thrombectomy, although larger prospective studies are necessary.

scholarly journals Body mass index and cardiovascular outcomes in patients with acute coronary syndrome by diabetes status: the obesity paradox in a Korean national cohort study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Se-Jun Park ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Body Mass ◽  
Obesity Paradox ◽  
Class Ii ◽  
Normal Weight ◽  
Class I ◽  
Coronary Syndrome ◽  
Obese Class ◽  
Diabetes Status

Abstract Background The “obesity paradox” has not been elucidated in the long-term outcomes of acute coronary syndrome (ACS). We investigated the association between obesity and cardiovascular (CV) outcomes in ACS patients with and without diabetes. Methods We identified 6978 patients with ACS aged 40–79 years from the Korean National Health Insurance Service-Health Screening Cohort between 2002 and 2015. Baseline body mass index (BMI) was categorized as underweight (< 18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2), and obese class II (≥ 30.0 kg/m2). The primary outcome was major adverse CV events (MACE)—CV death, myocardial infarction (MI), and stroke. The secondary outcomes were the individual components of MACE, hospitalization for heart failure (HHF), and all-cause death. Results After adjustment for confounding variables, compared to normal-weight patients without diabetes (reference group), obese class I patients with and without diabetes had a lower risk of MACE, but only significant in patients without diabetes (with diabetes: hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.78–1.14; without diabetes: HR 0.78, 95% CI 0.62–0.97). Obese class II patient with diabetes had a higher risk of MACE with no statistical significance (HR 1.14, 95% CI 0.82–1.59). Underweight patients with and without diabetes had a higher risk of MACE, but only significant in patients with diabetes (with diabetes: HR 1.79, 95% CI 1.24–2.58; without diabetes: HR 1.23, 95% CI 0.77–1.97). Conclusion In ACS patients, obesity had a protective effect on CV outcomes, especially in patients without diabetes.

Abstract 3206: Obesity Paradox in Acute Ischemic Stroke: Analysis of 34,132 Patients from Korean Stroke Registry

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Beom Joon Kim ◽  
Seung-Hoon Lee ◽  
Keun-Hwa Jung ◽  
Kyung-Ho Yu ◽  
Byung-Chul Lee ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Causes Of Death ◽  
Obesity Paradox ◽  
Inverse Association ◽  
Age Group ◽  
Stroke Patients ◽  
Stroke Registry ◽  
Risk Of Mortality ◽  
Obesity Status

Background. Paradoxical longevity in obese patients with established disease has been reported in various conditions. However, detailed investigations involving acute ischemic stroke patients are scarce. We aimed to detect obesity paradox in acute ischemic stroke patients with stratified analyses based on age and causes of mortality. Methods. Korean Stroke Registry (KSR) is a nationwide, multicenter and prospective registry of acute stroke. During 7.5 years, 34 132 acute ischemic stroke patients were collected through 30 participating centers. The mortality information was ascertained through a governmental statistical office, as current of December 2009. Multiple imputation by IVEware was used to estimate missing data on the basis of observed information and to account for potential variance due to uncertainty of missingness. Results. Among a total of 34,132 acute ischemic stroke patients analyzed in this study, 1,348 patients (4.7%) were classified as underweighted (BMI <18.5), 10,888 (37.7%) as normal weight (18.5 - 22.9), 7,666 (26.5%) as overweight (23 - 24.9), 8,056 (27.9%) as obesity I (25.0 - 29.9), and 924 (3.2%) as obesity II (≥30; BMI missing in 5,250 patients), at the time of admission. During mean follow-up of 32.6 ± 23.1 months, 9,073 patients (26.6%) were deceased up to June 2009. Mortality rates of the included patients at various time-points were as followed; 4.1% (1,410 subjects) at 1-month, 7.0% (2,394) at 3-month, and 13.0% (4,373) at 1-year after stroke. Compared with body mass index (BMI) value of 20 - 23, stroke survivors with lower BMI values had increased risk of mortality (HR 1.36, 95% CI 1.25 - 1.48 for BMI ≤18.5; HR 1.14, 95% CI 1.03 - 1.26 for BMI 18.5 - 20). Likewise, obese stroke patients had decreased risk of mortality (HR 0.83, 95% CI 0.74 - 0.92 for BMI 27.5 - 30; HR 0.77, 95% CI 0.63 - 0.93 for BMI 30 - 32.5; see Figure ). Inverse association between obesity status and mortality was not evident until 90 days after stroke, but became significant 1 year after onset of stroke. The association between obesity status and mortality was stronger in young-age group than in old-age group, but significance was maintained through all age-strata. The obesity paradox remained significant regardless of mortality causes, such as cancer death, vascular death and other causes of death. Conclusion. From our study, an inverse association between obesity status and long-term mortality in stroke survivors was documented, and such association was evident regardless of age or causes of death.

P3781Prognostic impact of body mass index on mortality and its causes in patients with atrial fibrillation: the Fushimi AF Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y An ◽  
M Iguchi ◽  
M Ishii ◽  
N Masunaga ◽  
Y Aono ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Obesity Paradox ◽  
Chronic Obstructive ◽  
Inverse Association ◽  
Community Based ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Obesity has been shown to be related to an increased risk for incidence and progression of atrial fibrillation (AF). Meanwhile, the inverse association between body mass index (BMI) and mortality, so-called “obesity paradox”, is well-known among patients with AF, as well as other cardiovascular diseases. However, data regarding the relationship between BMI and specific causes of death in AF patients remain scarce. Methods The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto. The inclusion criterion for the registry is the documentation of AF at 12-lead electrocardiogram or Holter monitoring at any time. We started to enroll patients from March 2011, and baseline characteristics including BMI and follow-up data were available for 3,805 patients by the end of November 2018. Patients were categorized into 3 groups depending on the BMI value; underweight (<18.5 kg/m2; 419 patients), normal (18.5 to <25.0 kg/m2; 2,283 patients), overweight (≤25.0 kg/m2; 1,103 patients). Results In the entire population, the mean BMI level was 23.1±4.0 kg/m2. The lower BMI was associated with higher age (78.5±10.3, 74.0±10.3, and 71.3±10.9 years in Underweight, Normal, and Overweight, respectively; p<0.001) and with higher prevalence of various comorbidities and CHA2DS2-VASc scores (3.83±1.67, 3.43±1.70, and 3.29±1.64, p<0.001). Oral anticoagulants were less frequently prescribed in those with lower BMI (46%, 56%, and 58%, p<0.001). During a median follow-up of 1,464 days (interquartile range: 727–2,228 days), all-cause mortality was lower in accordance with higher BMI (14.3, 5.3, and 3.5 per 100 person-years, respectively; p<0.001). The proportion of infection as a cause of death was prominently higher in the Underweight group than the others (25.7%, 16.7%, and 13.4%, p<0.001) (Figure A). Furthermore, the mortality due to infection was consistently higher in Underweight than in the others in any of the age subgroups (Figure B). Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the BMI value for mortality, adjusted by age, sex, chronic kidney disease, anemia, chronic obstructive pulmonary disease, history of major bleeding, and other components of CHA2DS2-VASc score. Higher BMI was related to lower all-cause mortality (per 5 kg/m2 increase: HR 0.71 [95% CIs 0.63–0.78], p<0.001), and also lower mortality due to infection (per 5 kg/m2 increase: HR 0.48 [95% CIs 0.37–0.61], p<0.001). Figure 1 Conclusions In a Japanese community-based AF cohort, obesity paradox was also observed on all-cause mortality. In particular, lower BMI was strongly associated with the mortality due to infection regardless of age. Acknowledgement/Funding Boehringer Ingelheim, Bayer Healthcare, Pfizer, Bristol-Myers Squibb, Astellas Pharma, AstraZeneca, Daiichi-Sankyo, Novartis Pharma, MSD, Sanofi-Avent

scholarly journals Frequency of Dyslipidemia in Ischemic Stroke Patients Presented to Tertiary Care Hospital of Lahore

2021 ◽  
Vol 15 (10) ◽  
pp. 3417-3419
Author(s):  
Murtaza Jaffar ◽  
Adil Rafique ◽  
Sidra Khalid ◽  
Shahid Waheed
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Blood Glucose ◽  
Family History ◽  
Body Mass ◽  
Fasting Blood Glucose ◽  
Stroke Patients ◽  
Blood Samples ◽  
Low Hdl

Background and Aim: A stroke, also known as a cerebrovascular accident, is defined as the sudden onset of a focal neurologic deficit caused by a disruption in blood flow to parts of the brain. The purpose of this study was to evaluate the frequency of dyslipidemia in stroke patients. Materials and Methods: This cross-sectional study was carried out on 184 stroke patients in Medical department of Services Hospital, Lahore for duration of six months i.e from November 2020 to June 2021. All the stroke patients admitted during the study period were enrolled. Demographic details, past medical and family history, stroke risk factors, blood pressure, body mass index, and diabetic state were noted. Fasting blood samples were taken from individuals of stroke diagnosed based on CT scan. Lipid profiles including triacylglycerol, cholesterol, fasting blood glucose, low-density lipoproteins, and glycosylated hemoglobin were all measured from an individual blood samples. SPSS version 20 was used for data analysis. Results: Of the total 184 stroke patients, 123 (66.8%) were male patients while 61 (33.2%) were females. The overall mean age was 41.35±12.76 years whereas the mean body mass index was 37.61±10.91 Kg/m2. Out of 184 patients, the prevalence of prevalent risk factors such as hypertension, diabetes mellitus, and smoking was found 146 (79.5%), 89 (48.2%), and 58 (31.7%) respectively. The prevalence of Hypercholesterolemia (mg/dl), Hypertriglyceridemia (mg/dl), High LDL (mg/dl) levels, high VLDL (mg/dl), and low HDL was 49 (26.4%), 37 (20.1%), 31 (16.8%), 23 (12.5%), and 13 (7.1%) respectively. The abnormalities in HbA1c and fasting blood glucose were found in 93 (50.6%) and 95 (51.4%). Conclusion: Dyslipidemia was more prevalent in ischemic stroke patients. The smoker and male population are more susceptible to stroke risks that involve high LDL, high HbA1c, low HDL, hypertension, and higher fast blood glucose. Family history and diabetes are other risk factors for stroke. Appropriate intrusion for alteration of uneven lipid profile can improve stroke prognosis and prevention Keywords: Dyslipidemia; Ischemic Stroke, Cholesterol

scholarly journals Carotid intima media thickness as a reflection of generalized atherosclerosis is related to body mass index in ischemic stroke patients

2013 ◽  
Vol 5 (3) ◽  
pp. 228
Author(s):  
AmitShankar Singh ◽  
Virendra Atam ◽  
MunnaLal Patel ◽  
ShyamChand Chaudhary ◽  
KamalKumar Sawlani ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Stroke Patients ◽  
Media Thickness
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