Favorable Functional Recovery in Overweight Ischemic Stroke Survivors: Findings from the China National Stroke Registry

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• 作者：Lu Zhao ; MD^&lowast ; ; Wanliang Du ; MD^&dagger ; ; Xingquan Zhao ; MD^&dagger ; ; Liping Liu ; MD^&dagger ; ; Chunxue Wang ; MD^&dagger ; ; Yilong Wang ; MD^&dagger ; ; Anxin Wang ; MD^&dagger ; ; Gaifen Liu ; PhD^&dagger ; ; Yongjun Wang ; MD^&dagger ; ; Yuming Xu ; MD^&lowast ; ; ^{xuyuming@zzu.edu.cn" class="auth_mail}
• 关键词：Body mass index ; ischemic stroke ; functional recovery ; mortality ; obesity paradox
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：March, 2014
• 年：2014
• 卷：23
• 期：3
• 页码：e201-e206
• 全文大小：197 K

文摘

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Background

Obesity paradox has been reported because of the inverse relationship between the body mass index (BMI) and mortality in stroke patients. The relationship between BMI and functional recovery in stroke survivors is less well established. We explored the impact of BMI on functional recovery and mortality in stroke patients in the China National Stroke Registry (CNSR).

Methods

Patients were consecutively recruited based on a standard protocol and prospectively followed up for outcomes at 3聽months after disease onset. Patients were divided into 5 groups according to their BMI: underweight (<18.5聽kg/m²), normal weight (18.5-22.9聽kg/m²), overweight (23-27.4聽kg/m²), obese (27.5-32.4聽kg/m²), or severely obese (鈮?2.5聽kg/m²). Multivariate logistic regression was performed to analyze the association between BMI and functional recovery or mortality.

Results

CNSR enrolled 22,216 patients hospitalized for acute cerebrovascular events, and 10,905 eligible acute ischemic stroke patients were analyzed in our study. Favorable functional recovery (modified Rankin Scale score 0-1) was seen in 52.4% of underweight, 55.0% of normal weight, 61.0% of overweight, 59.2% of obese, and 60.3% of severely obese stroke survivors (P聽<聽.001). Overweight was independently associated with favorable 3-month functional recovery (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.12-1.38). Mortality rate was 14.9% in underweight, 7.8% in normal weight, 7.1% in overweight, 7.2% in obese, and 11.5% in severely obese patients (P聽<聽.001). Severe obesity was independently associated with higher 3-month mortality (OR 2.01; 95% CI 1.10-3.69).

Conclusions

The stroke obesity paradox can be extended to include functional recovery but should not be interpreted as the fatter the better.