Mitchell Andrew B, Cole John W, McArdle Patrick F, Cheng Yu-Ching, Ryan Kathleen A, Sparks Mary J, Mitchell Braxton D, Kittner Steven J
From the Departments of Neurology (A.B.M., J.W.C., M.J.S., S.J.K.) and Medicine (P.F.M., Y.-C.C., K.A.R., B.D.M.), University of Maryland School of Medicine, Baltimore; and Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, MD (J.W.C., Y.-C.C., S.J.K.).
Stroke. 2015 Jun;46(6):1690-2. doi: 10.1161/STROKEAHA.115.008940. Epub 2015 May 5.
Body mass index has been associated with ischemic stroke in older populations, but its association with stroke in younger populations is not known. In light of the current obesity epidemic in the United States, the potential impact of obesity on stroke risk in young adults deserves attention.
A population-based case-control study design with 1201 cases and 1154 controls was used to investigate the relationship of obesity and young onset ischemic stroke. Stroke cases were between the ages of 15 and 49 years. Logistic regression analysis was used to evaluate the association between body mass index and ischemic stroke with and without adjustment for comorbid conditions associated with stroke.
In analyses adjusted for age, sex, and ethnicity, obesity (body mass index >30 kg/m(2)) was associated with an increased stroke risk (odds ratio, 1.57; 95% confidence interval, 1.28-1.94) although this increased risk was highly attenuated and not statistically significant after adjustment for smoking, hypertension, and diabetes mellitus.
These results indicate that obesity is a risk factor for young onset ischemic stroke and suggest that this association may be partially mediated through hypertension, diabetes mellitus, or other variables associated with these conditions.
体重指数与老年人群的缺血性卒中有关,但在年轻人群中其与卒中的关系尚不清楚。鉴于美国目前的肥胖流行情况,肥胖对年轻成年人卒中风险的潜在影响值得关注。
采用基于人群的病例对照研究设计,纳入1201例病例和1154例对照,以调查肥胖与年轻起病缺血性卒中的关系。卒中病例年龄在15至49岁之间。采用逻辑回归分析评估体重指数与缺血性卒中之间的关联,并对与卒中相关的合并症进行调整或未调整。
在对年龄、性别和种族进行调整的分析中,肥胖(体重指数>30 kg/m²)与卒中风险增加相关(比值比,1.57;95%置信区间,1.28 - 1.94),尽管在对吸烟、高血压和糖尿病进行调整后,这种增加的风险大幅减弱且无统计学意义。
这些结果表明肥胖是年轻起病缺血性卒中的一个危险因素,并提示这种关联可能部分通过高血压、糖尿病或与这些疾病相关的其他变量介导。