Department of Occupational Science and Occupational Therapy, Saint Louis University, 3437 Caroline St, Allied Health Building Room 2020, St. Louis, MO, 63104, USA.
Department of Medicine, Division of Geriatrics, Gerontology & Palliative Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; San Antonio Geriatric Research Education and Clinical Center, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX, 78229, USA.
Disabil Health J. 2020 Jul;13(3):100914. doi: 10.1016/j.dhjo.2020.100914. Epub 2020 Feb 21.
Stroke is the most common cause of complex disability. Obesity and diabetes increase risk for functional disability in the general population, but their contribution to functional disability in stroke survivors is unknown.
To investigate the joint association of obesity and diabetes with functional disability in stroke survivors.
Cross-sectional data from 34,376 stroke survivors from the 2015 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys were examined. Weighted and age-adjusted prevalence estimates and adjusted odds ratios (AOR, adjusted for sociodemographic characteristics) with 95% confidence intervals (CIs) were calculated to compare prevalence and odds for self-reported functional disability, stratified by obesity-diabetes status (i.e., neither condition, obesity only, diabetes only, both conditions).
Prevalence of functional disability increased across obesity-diabetes categories in the total sample: neither condition (45.4%, 95% CI: 43.4%-47.4%), obesity only (55.3%, 95% CI: 52.7%-58.0%), diabetes only (60.8%, 95% CI: 57.5%-64.1%), and both conditions (70.3%, 95% CI: 67.7%-72.9%). Compared to respondents with neither condition, those with both obesity and diabetes had 2.62 (95% CI: 2.23-3.08) higher odds for functional disability; odds were also increased for respondents with obesity only (1.52, 95% CI: 1.32-1.76) and diabetes only (1.71, CI: 1.45-2.01).
Our findings indicated a joint effect of obesity and diabetes on functional disability that exceeded either condition alone, placing stroke survivors with both health conditions at greatest risk for diminished functional capacity. Recognizing obesity and diabetes as modifiable risk factors may be useful for identifying stroke sub-populations that could benefit from lifestyle intervention.
中风是导致复杂残疾的最常见原因。肥胖症和糖尿病会增加普通人群发生功能障碍的风险，但它们对中风幸存者功能障碍的贡献尚不清楚。
调查肥胖症和糖尿病与中风幸存者功能障碍的联合关联。
使用 2015 年和 2017 年行为风险因素监测系统（BRFSS）调查的 34376 名中风幸存者的横断面数据。计算加权和年龄调整后的患病率估计值和调整后的优势比（AOR，调整社会人口统计学特征）及 95%置信区间（CI），以比较自我报告的功能障碍的患病率和优势，按肥胖-糖尿病状况分层（即无任何一种疾病、仅肥胖、仅糖尿病、两种疾病都有）。
在总样本中，随着肥胖-糖尿病类别的增加，功能障碍的患病率也在增加：无任何一种疾病（45.4%，95%CI：43.4%-47.4%）、仅肥胖（55.3%，95%CI：52.7%-58.0%）、仅糖尿病（60.8%，95%CI：57.5%-64.1%）和两种疾病都有（70.3%，95%CI：67.7%-72.9%）。与无任何一种疾病的受访者相比，同时患有肥胖症和糖尿病的受访者发生功能障碍的几率高 2.62 倍（95%CI：2.23-3.08）；仅肥胖（1.52，95%CI：1.32-1.76）和仅糖尿病（1.71，CI：1.45-2.01）的受访者发生功能障碍的几率也有所增加。
我们的研究结果表明，肥胖症和糖尿病对功能障碍的联合影响超过了任何一种疾病单独的影响，使同时患有这两种健康状况的中风幸存者的功能能力受损风险最大。将肥胖症和糖尿病视为可改变的危险因素，可能有助于确定可以从生活方式干预中受益的中风亚人群。
