Darke Shane, Duflou Johan, Kaye Sharlene, Farrell Michael, Lappin Julia
National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia.
National Drug & Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia; Sydney Medical School, University of Sydney, NSW, 2006, Australia.
J Forensic Leg Med. 2019 Apr;63:1-6. doi: 10.1016/j.jflm.2019.02.003. Epub 2019 Feb 14.
Rates of stroke and obesity have increased in recent years. This study aimed to determine the body mass index (BMI) of fatal stroke cases amongst young adults, their clinical characteristics and the association with BMI with risk factors. All cases aged 15-44 years where death was attributed to stroke for whom BMI was available were retrieved from the National Coronial Information System (1/1/2009-31/12/2016). 179 cases were identified: haemorrhagic (165), ischaemic (5), thrombotic (6), mycotic (3), embolic (0). Proportions in each BMI category were: underweight (5.6%), normal weight (37.4%), overweight (27.4%), obese (29.6%). There was a significant linear trend in the proportion of subarachnoid haemorrhages as BMI increased (p < 0.05), and between higher BMI and hypertension (p < 0.001). There were no group differences in cardiomegaly or left ventricular hypertrophy where known causes were other than hypertension, cardiomyopathy, severe coronary artery atherosclerosis, endocarditis or cerebral arteries atherosclerosis. A history of alcoholism (p < 0.01) was less likely with higher BMI. There was no association between BMI and previous stroke, diabetes, vasculitis, gravid/post-partum, tobacco use, psychostimulant use or injecting drug use. Overweight and obese cases were prominent among young fatalities of stroke. Reducing rates of obesity, and associated hypertension, would be expected to reduce the escalating stoke rates among young adults.
近年来，中风和肥胖的发病率有所上升。本研究旨在确定年轻成年人中致命性中风病例的体重指数（BMI）、其临床特征以及BMI与危险因素之间的关联。从国家死因信息系统（2009年1月1日至2016年12月31日）中检索所有年龄在15 - 44岁、死亡归因于中风且有BMI数据的病例。共识别出179例：出血性（165例）、缺血性（5例）、血栓性（6例）、霉菌性（3例）、栓塞性（0例）。各BMI类别中的比例分别为：体重过轻（5.6%）、正常体重（37.4%）、超重（27.4%）、肥胖（29.6%）。随着BMI增加，蛛网膜下腔出血的比例存在显著线性趋势（p < 0.05），且较高BMI与高血压之间也存在显著线性趋势（p < 0.001）。在已知病因不是高血压、心肌病、严重冠状动脉粥样硬化、心内膜炎或脑动脉粥样硬化的情况下，心脏肥大或左心室肥厚方面无组间差异。较高BMI者患酒精中毒史的可能性较小（p < 0.01）。BMI与既往中风、糖尿病、血管炎、妊娠/产后、吸烟、使用精神兴奋剂或注射吸毒之间无关联。超重和肥胖病例在年轻中风死亡者中较为突出。预计降低肥胖率以及相关的高血压率将降低年轻成年人中不断上升的中风发病率。
