State Key Laboratory of Cardiovascular Disease, Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
State Key Laboratory of Cardiovascular Disease, Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Atherosclerosis. 2016 Oct;253:94-101. doi: 10.1016/j.atherosclerosis.2016.08.042. Epub 2016 Aug 28.
Studies of the association between obesity and total mortality and recurrent stroke events have shown contradictory results. Therefore, we aimed to conduct a meta-analysis to examine the association of body mass index (BMI) with total mortality and recurrent stroke events among patients after stroke onset.
We performed an electronic search of PubMed, EMBASE and the Cochrane Library Database, as well as a bibliography review to identify relevant cohort studies published prior to 15th December 2015. Estimates of relative risks (RRs) and corresponding 95% confidence intervals (CIs) comparing underweight, overweight and obese groups with normal weight were pooled using random effects models.
In total, 15 studies with 122,472 stroke patients were eligible for inclusion in the meta-analysis. Compared with the normal weight group, obese stroke patients had a significant decreased risk for total mortality (RR = 0.83, 95% CI, 0.73-0.93, p = 0.002), while underweight patients had a significant increased risk for total mortality (RR = 1.54, 95% CI, 1.31-1.82, p = 3.66 × 10). A similar, but not significant, association of BMI categories with recurrent stroke events was also observed. Furthermore, the dose-response meta-analysis identified a nonlinear trend for total mortality and a linear trend for recurrent stroke events, associated with BMI.
Our results suggested that obesity may have a protective effect on total mortality and recurrent stroke events among patients with established stroke.
肥胖与全因死亡率和复发性卒中事件之间关联的研究结果相互矛盾。因此，我们旨在进行一项荟萃分析，以检验卒中发病后患者的体重指数（BMI）与全因死亡率和复发性卒中事件之间的相关性。
我们对 PubMed、EMBASE 和 Cochrane 图书馆数据库进行了电子检索，并对参考文献进行了回顾，以确定截至 2015 年 12 月 15 日之前发表的相关队列研究。使用随机效应模型对比较消瘦、超重和肥胖组与正常体重组的相对危险度（RR）和相应的 95%置信区间（CI）进行了汇总。
共有 15 项研究纳入了 122472 例卒中患者，符合荟萃分析的纳入标准。与正常体重组相比，肥胖卒中患者的全因死亡率显著降低（RR=0.83，95%CI，0.73-0.93，p=0.002），而消瘦患者的全因死亡率显著升高（RR=1.54，95%CI，1.31-1.82，p=3.66×10）。BMI 类别与复发性卒中事件之间也观察到类似的但无统计学意义的相关性。此外，剂量-反应荟萃分析确定了 BMI 与全因死亡率之间存在非线性趋势，与复发性卒中事件之间存在线性趋势。
我们的结果表明，肥胖可能对已确诊卒中患者的全因死亡率和复发性卒中事件具有保护作用。
