Abstract T P140: The Intriguing Metabolically Healthy but Obese Phenotype:Association With the Prognosis After Ischemic Stroke

Abstract

Background & Objective: “Metabolically healthy but obese phenotype” is defined as individuals with overweight or obese without metabolic complication. They seemed to be protected against obesity related morbidity, and have a lower risk for cardiovascular and all cause of mortality even than normal weighted individuals. However, the impact of this interesting subgroup on the prognosis after stroke has not been evaluated. The purpose of this study was to assess whether the metabolically healthy but obese phenotype would have a lower risk of poor outcome after stroke compared to other metabolic phenotypes Methods: We collected the data of 645 patients with ischemic stroke. The patients were classed as normal weight (body mass index[BMI] 18.5-22.9 kg/ m2), overweight to obese (BMI≥23 kg/ m2). The patients who met 0 or 1 of the criteria of metabolic syndrome were classified as metabolically healthy. The functional outcome was defined using modified rankin scale 3 months after the index stroke (good, grade 0 to 1 vs. poor, grade 2 to 6). Logistic regression analyses were used to examine the association between the phenotypes and poor outcome. Results: Among the total patients, 122 (18.9%) patients were included as “Metabolically healthy but obese” group. As “Metabolically healthy but obese group” was a referent, “Normal weight but metabolically unhealthy” (adjusted odds ratio [OR], 3.61, 95% confidential interval [CI], 1.73-7.51, p<0.01), and “Obese and metabolically unhealthy” groups were associated with poor outcome (adjusted OR 2.11, 95% CI 1.03-4.11, p=0.04). The association between “Normal weight and metabolically healthy” phenotype and poor outcome was not statistically significant. Conclusions: In this study, we showed that metabolically unhealthy patients, even though they had normal weight, were likely to have a threefold increased risk of poor functional outcome compared to the “Metabolically healthy but obese” patients. The metabolic status of patients should be considered with obesity itself in predicting the prognosis of ischemic stroke.