Kang Kyusik, Lee Wong-Woo, Lee Jung-Ju, Park Jong-Moo, Kwon Ohyun, Kim Byung Kun
Department of Neurology, Nowon Eulji Medical Center, Eulji University, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Republic of Korea.
J Thromb Thrombolysis. 2017 Aug;44(2):238-244. doi: 10.1007/s11239-017-1508-y.
Although a positive association between body mass index (BMI) and stroke incidence has been reported, having a higher BMI is known to be advantageous in surviving and recovering from stroke. The association between adiposity and stroke incidence is more evident for measures of abdominal obesity than for general obesity. The aim of our study was to compare BMI, waist circumference, and waist-height ratio (WHR) as predictors of 3-month functional outcome in stroke patients. The BMI, waist circumference, and WHR of acute stroke patients were divided into sex-specific quartiles. A total of 605 female and 727 male patients were included. For BMI, male patients in the second quartile were more likely to have a favorable functional outcome compared with those in the lowest quartile (adjusted OR 1.64, 95% CI 1.02-2.62). For waist circumference (adjusted OR for top quartile vs. lowest quartile 1.79, 95% CI 1.14-2.82) and WHR (adjusted OR for second quartile vs. lowest quartile 1.99, 95% CI 1.22-3.25), male patients in the two top quartiles were more likely to have a favorable functional outcome compared with those in the respective lowest quartile. BMI and WHR showed similar relationships to a favorable functional outcome, with a favorable functional outcome occurring most often among male patients in the second quartiles. In women, however, obesity was not related to functional outcome. In conclusion, general obesity measured by BMI and abdominal obesity measured by WHR showed similar effects on the functional outcome after stroke in men.
尽管已有报道称体重指数（BMI）与中风发病率之间存在正相关，但较高的BMI在中风后的存活和康复方面具有优势。与一般肥胖相比，腹部肥胖指标与中风发病率之间的关联更为明显。我们研究的目的是比较BMI、腰围和腰高比（WHR）作为中风患者3个月功能结局预测指标的情况。急性中风患者的BMI、腰围和WHR被分为按性别划分的四分位数。共纳入605名女性患者和727名男性患者。就BMI而言，与处于最低四分位数的男性患者相比，处于第二四分位数的男性患者更有可能获得良好的功能结局（调整后的比值比为1.64，95%置信区间为1.02 - 2.62）。就腰围（最高四分位数与最低四分位数相比的调整后比值比为1.79，95%置信区间为1.14 - 2.82）和WHR（第二四分位数与最低四分位数相比的调整后比值比为1.99，95%置信区间为1.22 - 3.25）而言，处于两个最高四分位数的男性患者与各自处于最低四分位数的男性患者相比，更有可能获得良好的功能结局。BMI和WHR与良好功能结局的关系相似，在第二四分位数的男性患者中最常出现良好的功能结局。然而，在女性中，肥胖与功能结局无关。总之，通过BMI衡量的一般肥胖和通过WHR衡量的腹部肥胖对男性中风后的功能结局显示出相似的影响。
