Li Zhao, Guo Xiaofan, Liu Yamin, Zhang Naijin, Chang Ye, Chen Yintao, Sun Yingxian, Abraham Maria Roselle
Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning People's Republic of China.
Department of Pharmacy, Zhongda Hospital, Southeast University, Nanjing, Jiangsu People's Republic of China.
Springerplus. 2016 Aug 25;5(1):1419. doi: 10.1186/s40064-016-3088-2. eCollection 2016.
Little is known about stroke with different obesity phenotype as determined using the Adult Treatment Panel-III criteria with metabolic health or not. This study aimed to investigate the effects of metabolically healthy and unhealthy obesity on ischemic stroke in a general population. A total of 11,150 adults were examined using a multi-stage cluster sampling method to select a representative sample of individuals 35 years or older. Ischemic stroke was defined as history of a cerebrovascular event, as documented by doctors via either cranial CT or MR scan within the past 2 years. All subjects were categorized as having metabolically healthy non-obesity (MHNO), metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) using the Adult Treatment Panel-III criteria. Stratified analysis were done based on different body mass index group. For the total population, multiple regression analyses revealed that individuals with MUNO and MUO were more likely to experience ischemic stroke compared with those with MHNO (OR 2.136, 95 % CI 1.677-2.720; OR 2.712, 95 % CI 1.798-4.092; all p < 0.001). The OR for ischemic stroke did not significantly differ between MHO and MHNO. Stratification based on different BMI group showed that, compared with people who were normal weight without Mes, participants who were in Mes with overweight or obesity had significantly higher OR for ischemic stroke(both p < 0.05); participants who were not in Mes with overweight or obesity did not showed OR significantly higher. Ischemic stroke is likely associated with poor metabolic health rather than with obesity itself.
关于根据成人治疗小组第三次报告标准确定的不同肥胖表型（无论代谢是否健康）与中风之间的关系，人们知之甚少。本研究旨在调查代谢健康型肥胖和代谢不健康型肥胖对普通人群缺血性中风的影响。采用多阶段整群抽样方法对11150名35岁及以上成年人进行检查，以选取具有代表性的样本。缺血性中风定义为有脑血管事件史，由医生在过去2年内通过头颅CT或磁共振扫描记录在案。使用成人治疗小组第三次报告标准，将所有受试者分为代谢健康非肥胖（MHNO）、代谢不健康非肥胖（MUNO）、代谢健康肥胖（MHO）或代谢不健康肥胖（MUO）。根据不同体重指数组进行分层分析。对于总体人群，多元回归分析显示，与MHNO者相比，MUNO和MUO者发生缺血性中风的可能性更高（OR 2.136，95%CI 1.677 - 2.720；OR 2.712，95%CI 1.798 - 4.092；均p < 0.001）。MHO和MHNO者之间缺血性中风的OR无显著差异。根据不同BMI组进行分层显示，与体重正常且无代谢异常的人相比，超重或肥胖且有代谢异常的参与者缺血性中风的OR显著更高（均p < 0.05）；超重或肥胖但无代谢异常的参与者缺血性中风的OR未显著升高。缺血性中风可能与代谢健康状况不佳有关，而非与肥胖本身有关。
