scholarly journals Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2343
Author(s):  
Masahiro Shiozawa ◽  
Hidehiro Kaneko ◽  
Hidetaka Itoh ◽  
Kojiro Morita ◽  
Akira Okada ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Hemorrhagic Stroke ◽  
Stroke Risk ◽  
Cox Regression ◽  
Cubic Spline ◽  
Overweight And Obesity ◽  
Dependent Manner ◽  
Men And Women

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m2). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.

scholarly journals Estimate of prevalent ischemic stroke from triglyceride glucose-body mass index in the general population

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhi Du ◽  
Liying Xing ◽  
Min Lin ◽  
Yingxian Sun
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
General Population ◽  
Body Mass ◽  
Density Lipoprotein ◽  
Cubic Spline ◽  
Lipoprotein Cholesterol ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
The Relationship

Abstract Background To investigate the relationship between triglyceride glucose-body mass index (TyG-BMI) and ischemic stroke. Methods Leveraging two Chinese general population surveys, the Northeast China Rural Cardiovascular Health Study (NCRCHS, N = 11,097) and the National Stroke Screening and Intervention Program in Liaoning (NSSIPL, N = 10,862), we evaluated the relationship between TyG-BMI and ischemic stroke by a restricted cubic spline and multivariate logistic regression after adjusting age, sex, level of education, exercise regularly, current smoking, current drinking, atrial fibrillation, hypertension, coronary artery disease, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The category-free analysis was used to determine whether TyG-BMI enhanced the capacity of estimating ischemic stroke. Results A total of 596 and 347 subjects, respectively, from NSSIPL and NCRCHS were survivors of ischemic stroke. In NSSIPL, the relationship between TyG-BMI and ischemic stroke was linear and did not have a threshold or saturation effect according to the results of the restricted cubic spline. The regression analysis indicated that the risk of ischemic stroke increased 20% for per SD increase of TyG-BMI after multivariate adjustment [odds ratio (OR): 1.20, 95% confidence interval (CI): 1.10–1.32]. Compared with those in the lowest tertile, the risk of ischemic stroke in subjects with intermediate and high TyG-BMI was significantly higher [OR (95% CI): 1.39 (1.10–1.74); OR (95% CI) 1.72 (1.37–2.17), respectively]. Category-free analysis indicated that TyG-BMI had a remarkable improvement in the ability to estimate prevalent ischemic stroke [NRI (95% CI): 0.188 (0.105–0.270)]. These abovementioned relationships were confirmed in NCRCHS. Conclusions The present study found the robust correlation between TyG-BMI and ischemic stroke, independently of a host of conventional risk factors. Meanwhile, our findings also suggested the potential usefulness of TyG-BMI to improve the risk stratification of ischemic stroke.

Body mass index, overweight and obesity in married and never married men and women in Poland

2002 ◽  
Vol 14 (4) ◽  
pp. 468-475 ◽  
Author(s):  
Anna Lipowicz ◽  
Stanislaw Gronkiewicz ◽  
Robert M. Malina
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Overweight And Obesity ◽  
Men And Women ◽  
Never Married ◽  
Married Men

scholarly journals Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex

Antioxidants ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. 537 ◽  
Author(s):  
Anna Tresserra-Rimbau ◽  
Sara Castro-Barquero ◽  
Facundo Vitelli-Storelli ◽  
Nerea Becerra-Tomas ◽  
Zenaida Vázquez-Ruiz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Cox Regression ◽  
Overweight And Obesity ◽  
Cross Sectional ◽  
Dietary Polyphenols ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Overweight and obesity are important risk factors for type 2 diabetes (T2D). Moving towards healthier diets, namely, diets rich in bioactive compounds, could decrease the odds of suffering T2D. However, those individuals with high body mass index (BMI) may have altered absorption or metabolism of some nutrients and dietary components, including polyphenols. Therefore, we aimed to assess whether high intakes of some classes of polyphenols are associated with T2D in a population with metabolic syndrome and how these associations depend on BMI and sex. This baseline cross-sectional analysis includes 6633 participants from the PREDIMED-Plus trial. Polyphenol intakes were calculated from food frequency questionnaires (FFQ). Cox regression models with constant time at risk and robust variance estimators were used to estimate the prevalence ratios (PRs) for polyphenol intake and T2D prevalence using the lowest quartile as the reference group. Analyses were stratified by sex and BMI groups (overweight and obese) to evaluate potential effect modification. Catechins, proanthocyanidins, hydroxybenzoic acids, and lignans were inversely associated with T2D. Hydroxycinnamic acids were directly related in men. These associations were different depending on sex and BMI, that is, women and overweight obtained stronger inverse associations.

scholarly journals Impact of Body Mass Index on Survival of Metastatic Renal Cancer

2021 ◽  
Vol 8 (2) ◽  
pp. 49-54
Author(s):  
Jose Javier Salgado ◽  
Sergio Fernandez-Pello ◽  
Laura Ruger ◽  
Ivan Gonzalez ◽  
Laura Alonso ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Overall Survival ◽  
Body Mass ◽  
Cox Regression ◽  
Overweight And Obesity ◽  
Metastatic Renal Cancer ◽  
Low Bmi ◽  
Metastatic Rcc ◽  
High Bmi

Obesity has been established as a risk factor for renal cell carcinoma (RCC). Recently, studies have described obesity as a probable protecting factor in the metastatic stage of RCC. In this study, we assessed the relationship between body mass index (BMI) and overall survival in patients under systemic therapy.The correlation between BMI and overall median survival was studied in 76 patients diagnosed with metastatic RCC under systemic therapy. The groups were divided into overweight and obesity (BMI > 25 kg/m2) and underweight or normal (BMI < 25 kg/m2). Statistical analysis was performed using the Cox regression model adjusted by gender.A total of 76 patients were studied: 16 women (21%) and 60 men (79%). The median BMI was 27.96 kg/m2; 24 patients (31.6%) had low BMI and 52 (68.4%) had high BMI. Median overall survival in the group with BMI > 25 kg/m2 was 17 months (95% confidence interval [CI]: 13–34 months), while in the group with BMI ≤ 25 kg/m2, it was 14 months (95% CI: 8–20 months). When adjusted by gender, the group with BMI > 25 kg/m2 presented a hazards ratio of 0.54 (95% CI: 0.30–0.96), P = 0.044 (Log Rank).A high BMI significantly acts as a protecting factor. We observed an increased overall survival of overweight and obese patients within the context of metastatic RCC under systemic treatment. These data confirm the findings published in other studies that suggest the role of lipid metabolism in this type of tumors.

scholarly journals Factor XII as a Risk Marker for Hemorrhagic Stroke: A Prospective Cohort Study

2017 ◽  
Vol 7 (1) ◽  
pp. 84-94 ◽  
Author(s):  
Kristina Johansson ◽  
Jan-Håkan Jansson ◽  
Lars Johansson ◽  
Ingemar Bylesjö ◽  
Torbjörn K. Nilsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Body Mass Index ◽  
Regression Analysis ◽  
Cohort Study ◽  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Cox Regression ◽  
Factor Xii ◽  
Cox Regression Analysis

Background: Coagulation factor XII (FXII) is involved in pathological thrombus formation and is a suggested target of anticoagulants. It is unclear whether FXII levels are correlated with cardiovascular risk factors and whether they are associated with myocardial infarction or ischemic or hemorrhagic stroke. The aim of this study was to investigate the correlation between FXII and cardiovascular risk factors in the general population. We also aimed to study the associations between FXII levels and future myocardial infarction and ischemic and hemorrhagic stroke. Methods: This prospective cohort study measured FXII levels in 1,852 randomly selected participants in a health survey performed in northern Sweden in 1994. Participants were followed until myocardial infarction, stroke, death, or until December 31, 2011. Results: During the median follow-up of 17.9 years, 165 individuals were diagnosed with myocardial infarction, 108 with ischemic stroke, and 30 with hemorrhagic stroke. There were weak correlations between FXII and body mass index, cholesterol, and hypertension. There was no association between FXII and myocardial infarction or ischemic stroke, neither in univariable Cox regression analysis nor after adjustment for age, sex, smoking, body mass index, cholesterol, hypertension, and diabetes. In univariable Cox regression analysis, the hazard ratio for the association between FXII levels and hemorrhagic stroke was 1.42 per SD (95% confidence interval: 0.99–2.05). In the multivariable model, higher levels of FXII were associated with increased risk of hemorrhagic stroke (hazard ratio 1.51 per SD; 95% confidence interval: 1.03–2.21). Conclusion: We found an independent association between FXII levels and the risk of hemorrhagic stroke, but not between FXII levels and ischemic stroke or myocardial infarction.

scholarly journals Effects of Hypothetical Interventions on Ischemic Stroke Using Parametric G-Formula

Stroke ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 3286-3288 ◽  
Author(s):  
Yaser Mokhayeri ◽  
Seyed Saeed Hashemi-Nazari ◽  
Soheila Khodakarim ◽  
Saeid Safiri ◽  
Nasrin Mansournia ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Time Dependent ◽  
Lipoprotein Cholesterol ◽  
Men And Women ◽  
Quitting Smoking ◽  
Using Data

Background and Purpose— Standard analytic approaches (eg, logistic regression) fail to adequately control for time-dependent confounding and, therefore, may yield biased estimates of the total effect of the exposure on the outcome. In the present study, we estimate the effect of body mass index, intentional physical activity, HDL (high-density lipoprotein) cholesterol, LDL (low-density lipoprotein) cholesterol, hypertension, and cigarette smoking on the 11-year risk of ischemic stroke by sex using the parametric g-formula to control time-dependent confounders. Methods— Using data from the MESA (Multi-Ethnic Study of Atherosclerosis), we followed 6809 men and women aged 45 to 84 years. We estimated the risk of stroke under 6 hypothetical interventions: maintaining body mass index <25 kg/m 2 , maintaining normotension (systolic blood pressure <140 and diastolic <90 mm Hg), quitting smoking, maintaining HDL >1.55 mmol/L, maintaining LDL <3.11 mmol/L, and exercising at least 210 minutes per week. The effects of joint hypothetical interventions were also simulated. Results— In men, the 11-year risk of ischemic stroke would be reduced by 85% (95% CI, 66–96) for all 6 hypothetical interventions. In women, this same effect was estimated as 55% (95% CI, 6–82). Conclusions— The hypothetical interventions explored in our study resulted in risk reduction in both men and women.

scholarly journals Age at Menopause and Risk of Ischemic and Hemorrhagic Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Sabrina J.G.C. Welten ◽  
N. Charlotte Onland-Moret ◽  
Jolanda M.A. Boer ◽  
W.M. Monique Verschuren ◽  
Yvonne T. van der Schouw
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Stroke Risk ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Natural Menopause ◽  
Age At Menopause ◽  
Increased Risk ◽  
Surgical Menopause

Background and Purpose: The few epidemiological studies that addressed the association between age at menopause and ischemic and hemorrhagic stroke risk in women had conflicting findings. We aimed to investigate whether age at (natural and surgical) menopause is a risk factor for total, ischemic, and hemorrhagic stroke in women. Methods: We analyzed data from 16 244 postmenopausal women, aged 26 to 70 years at recruitment who were enrolled in the European Prospective Investigation into Cancer and Nutrition–Netherlands cohort between 1993 and 1997. Participants were followed for the occurrence of stroke until January 1, 2011. At baseline, participants filled in questionnaires about health, reproductive history including age at menopause, diet, and lifestyle. Cox regression was used to investigate the association between age at menopause and stroke. All analyses were adjusted for age, smoking, systolic blood pressure, and body mass index. Results: Mean age of menopause was 46.4 (7.0) years. A total of 830 strokes (571 ischemic, 162 hemorrhagic, 97 unclassified) were identified. Earlier menopause was associated with an increased risk of total stroke. Compared with women who experienced menopause between 50 and 54 years old, women who underwent menopause before age 40 years had 1.48× higher risk (95% CI, 1.19–1.85) of total stroke. In continuous analyses, we observed a 2% lower total stroke risk for each year menopause was delayed (hazard ratio, 0.98 [95% CI, 0.97–0.99]). The risk between earlier menopause and stroke was confined to ischemic stroke, earlier menopause was not associated with hemorrhagic stroke. The association with age at menopause was stronger for natural menopause (hazard ratio <40 versus 50–54 years, 1.74 [95% CI, 1.12–2.70]) than for surgical menopause (hazard ratio <40 versus 50–54 years, 1.26 [95% CI, 0.84–1.89]). Conclusions: The risk of total and ischemic stroke decreased with an increase in age at menopause. Whether this should have clinical consequences such as intensified risk factor control should be subject of further studies.

scholarly journals Association between Body Mass Index and Stroke Risk Among Patients with Type 2 Diabetes

2019 ◽  
Vol 105 (1) ◽  
pp. 96-105 ◽  
Author(s):  
Yun Shen ◽  
Lizheng Shi ◽  
Elizabeth Nauman ◽  
Peter T Katzmarzyk ◽  
Eboni G Price-Haywood ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Body Mass ◽  
Hemorrhagic Stroke ◽  
Stroke Risk ◽  
Reference Group ◽  
Research Network ◽  
Common Data Model ◽  
Inverse Association

Abstract Context Very few studies focused on the association between body mass index (BMI) and stroke risk among patients with diabetes. Objective We aimed to investigate the association between BMI and stroke risk in patients with type 2 diabetes. Design Demographic, anthropometric, laboratory, and medication information were extracted from the National Patient-Centered Clinical Research Network common data model. Participants We performed a retrospective cohort study of 67 086 patients with type 2 diabetes. Main Outcome Measures Incident stroke including both ischemic and hemorrhagic stroke were defined. Results During a mean follow up of 3.74 years. 8918 incident stroke events occurred. Multivariable-adjusted hazard ratios across different categories of BMI at baseline (18.5–24.9 [reference group], 25.0–29.9, 30.0–34.9, 35.0–39.9, and ≥40 kg/m2) were 1.00, 0.92, 0.85, 0.74, and 0.63 (Ptrend &lt;0.001) for total stroke; 1.00, 0.93, 0.88, 0.77, and 0.65 (Ptrend &lt;0.001) for ischemic stroke; and 1.00, 0.79, 0.50, 0.50, and 0.41 (Ptrend &lt;0.001) for hemorrhagic stroke, respectively. When we used an updated mean value of BMI, the graded inverse association of body mass index with stroke risk did not change. This linear association was consistent among patients of different subgroups. Further sensitivity analysis excluding patients who were diagnosed stroke within 6 months after first diagnosis of type 2 diabetes or including non-smokers only also confirmed our findings. Conclusion The present study found an inverse association between BMI and the risk of total, ischemic, and hemorrhagic stroke among patients with type 2 diabetes. More clinical and molecular insights are still needed in explaining these findings.

scholarly journals Modifiable Lifestyle Factors and Risk of Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Eric L. Harshfield ◽  
Marios K. Georgakis ◽  
Rainer Malik ◽  
Martin Dichgans ◽  
Hugh S. Markus
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Body Mass ◽  
Stroke Risk ◽  
Causal Effect ◽  
Lifestyle Factors ◽  
Small Vessel ◽  
Large Artery ◽  
Modifiable Lifestyle Factors

Background and Purpose: Assessing whether modifiable risk factors are causally associated with stroke risk is important in planning public health measures, but determining causality can be difficult in epidemiological data. We evaluated whether modifiable lifestyle factors including educational attainment, smoking, and body mass index are causal risk factors for ischemic stroke and its subtypes and hemorrhagic stroke. Methods: We performed 2-sample and multivariable Mendelian randomization to assess the causal effect of 12 lifestyle factors on risk of stroke and whether these effects are independent. Results: Genetically predicted years of education was inversely associated with ischemic, large artery, and small vessel stroke, and intracerebral hemorrhage. Genetically predicted smoking, body mass index, and waist-hip ratio were associated with ischemic and large artery stroke. The effects of education, body mass index, and smoking on ischemic stroke were independent. Conclusions: Our findings support the hypothesis that reduced education and increased smoking and obesity increase risk of ischemic, large artery, and small vessel stroke, suggesting that lifestyle modifications addressing these risk factors will reduce stroke risk.

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