Association Between Obesity and Post-stroke Anxiety in Patients With Acute Ischemic Stroke.

Bei-Lei Zhu,Gui-Qian Huang,Yi-Ting Ruan,Cheng-Xiang Yuan,Jin-Cai He,Xian-Chai Hong,Ai-Yi Hu,Bo Yang,Hui-Hua Qiu,Ping-Lang Hu

doi:10.3389/fnut.2021.749958

Abstract

Post-stroke anxiety (PSA) is serious psychosomatic comorbidity among patients with stroke, but whether obesity could be positively associated with PSA is currently unknown. The purpose of this study was to investigate the potential association between obesity and subsequent anxiety risk in patients with stroke. A total of 441 patients with acute ischemic stroke (AIS) onset were consecutively recruited within 7 days, and PSA and post-stroke depression (PSD) were evaluated by using a 14-item Hamilton anxiety scale (HAMA) and 17-item Hamilton depression scale (HAMD) at the end of 1-month follow-up. The odds ratio (OR) with 95% CI was estimated for the incidental PSA by using logistic regression analysis. The incidence of PSA was 25.85% at the end of 1-month follow-up, with a significant difference between patients with and without abdominal obesity. Relative fat mass (RFM) and abdominal obesity were significantly associated with an elevated risk of PSA, and the crude ORs were 1.04 (95% CI: 1.01–1.08) and 1.93 (95% CI: 1.11–3.34), respectively. Even after adjustment for obesity-related risk factors and PSA-related clinical measurements, the association remained to be pronounced with abdominal obesity. However, RFM (OR = 1.03, 95% CI: 0.99–1.06, P = 0.053) and abdominal obesity (OR = 1.31, 95% CI: 0.80–2.15, P = 0.280) were not significantly associated with an elevated risk of PSD. Abdominal obesity was independently associated with the PSA instead of PSD, which may help predict PSA risk in clinical practice. Further prospective clinical studies with a long follow-up duration are warranted to verify this finding.

Highlights

Stroke is a major cause of long-term disability in elderly people, and stroke-related high morbidity, disability, and mortality have become a global public health problem in the world [1]
The incidence of Post-stroke anxiety (PSA) and post-stroke depression (PSD) was 25.85% and 35.60% at the end of 1-month follow-up, respectively
We found significant differences between patients with PSA and non-PSA in National Institutes of Health Stroke Scale (NIHSS) score (P = 0.003), Barthel Index (BI) score (P < 0.001), fasting plasma glucose (P = 0.024), height (P = 0.010), Relative fat mass (RFM) (P = 0.012), and abdominal obesity (P = 0.018)

Summary

Introduction

Stroke is a major cause of long-term disability in elderly people, and stroke-related high morbidity, disability, and mortality have become a global public health problem in the world [1]. Post-stroke anxiety (PSA) is a common and serious psychosomatic comorbidity among patients with stroke [2]. A previous study showed that anxiety disorders diagnosed occurred in ∼20–25% of patients during any time of onset stroke [3]. Several studies showed that 21% of patients with stroke suffered from moderate or severe anxiety when stroke in 3 months after a stroke [4], and the frequency of PSA was 18% at 2 years [5]. The prognosis of PSA is poor and PSA interferes substantially with. Obesity and Post-stroke Anxiety social life and functional recovery [6]. Early identification of PSA is of great significance to improve the stroke prognosis

Objectives

Methods

Results