Kang Kyusik, Lee Wong-Woo, Lee Jung-Ju, Park Jong-Moo, Kwon Ohyun, Kim Byung Kun
a Department of Neurology , Nowon Eulji Medical Center, Eulji University , Seoul , Republic of Korea.
Neurol Res. 2018 Sep;40(9):785-794. doi: 10.1080/01616412.2018.1479346. Epub 2018 Jun 1.
Although higher body mass index (BMI) was reported to be associated with increased stroke incidence, having a higher BMI is known to be associated with better clinical outcomes after stroke. However, BMI has shown conflicting associations with baseline stroke severity. The aim of our study was to assess the relationship between waist circumference (WC) at admission and baseline stroke severity among patients with ischaemic stroke.
The WC of acute stroke patients was divided into sex-specific quartiles. Baseline stroke severity was categorised as mild [National Institutes of Health Stroke Scale (NIHSS) score 0-4], moderate (NIHSS score 5-10), and severe (NIHSS score ≥11). Multinomial logistic regression was used and reference categories were men or women in the lowest sex-specific WC quartiles who had experienced a mild stroke.
A total of 637 female and 766 male patients were included. The adjusted OR of severe stroke were 1.3 (95% CI, 0.7-2.4) for male patients in the third WC quartile, 0.7 (95% CI, 0.3-1.5) for male patients in the second WC quartile, and 0.4 (95% CI, 0.2-0.8) for male patients in the top WC quartile. The adjusted OR of severe stroke for female patients in the third WC quartile, the second WC quartile, and the top WC quartile were 0.8 (95% CI, 0.4-1.5), 0.4 (95% CI, 0.2-0.9), and 0.7 (95% CI, 0.3-1.3), respectively.
Higher WC at admission is associated with milder baseline stroke severity among patients with acute ischaemic stroke.
BMI: body mass index; CE: cardioembolism; CI: confidence interval; LAA: large-artery atherosclerosis; NIHSS: National Institutes of Health Stroke Scale; OR: odds ratio; SAO: small-artery occlusion; WC: waist circumference.
虽然据报道较高的体重指数（BMI）与中风发病率增加有关，但较高的BMI与中风后更好的临床结局相关。然而，BMI与基线中风严重程度之间的关联存在矛盾。我们研究的目的是评估缺血性中风患者入院时腰围（WC）与基线中风严重程度之间的关系。
急性中风患者的WC按性别分为四分位数。基线中风严重程度分为轻度[美国国立卫生研究院卒中量表（NIHSS）评分0 - 4]、中度（NIHSS评分5 - 10）和重度（NIHSS评分≥11）。采用多项逻辑回归分析，参考类别为经历轻度中风且处于最低性别特异性WC四分位数的男性或女性。
共纳入637例女性患者和766例男性患者。处于WC第三四分位数的男性患者发生严重中风的校正比值比（OR）为1.3（95%置信区间[CI]，0.7 - 2.4），处于WC第二四分位数的男性患者为0.7（95% CI，0.3 - 1.5），处于WC最高四分位数的男性患者为0.4（95% CI，0.2 - 0.8）。处于WC第三四分位数、第二四分位数和最高四分位数的女性患者发生严重中风的校正OR分别为0.8（95% CI，0.4 - 1.5）、0.4（95% CI，0.2 - 0.9）和0.7（95% CI，0.3 - 1.3）。
急性缺血性中风患者入院时较高的WC与较轻的基线中风严重程度相关。
BMI：体重指数；CE：心源性栓塞；CI：置信区间；LAA：大动脉粥样硬化；NIHSS：美国国立卫生研究院卒中量表；OR：比值比；SAO：小动脉闭塞；WC：腰围
