Metabolism rather than obesity is associated with ischemic stroke: a cross-sectional study in rural Northeastern China.

Zhao Li,Maria Roselle Abraham,Xiaofan Guo,Yamin Liu,Naijin Zhang,Ye Chang,Yingxian Sun,Yintao Chen

doi:10.1186/s40064-016-3088-2

Abstract

Little is known about stroke with different obesity phenotype as determined using the Adult Treatment Panel-III criteria with metabolic health or not. This study aimed to investigate the effects of metabolically healthy and unhealthy obesity on ischemic stroke in a general population. A total of 11,150 adults were examined using a multi-stage cluster sampling method to select a representative sample of individuals 35 years or older. Ischemic stroke was defined as history of a cerebrovascular event, as documented by doctors via either cranial CT or MR scan within the past 2 years. All subjects were categorized as having metabolically healthy non-obesity (MHNO), metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO) using the Adult Treatment Panel-III criteria. Stratified analysis were done based on different body mass index group. For the total population, multiple regression analyses revealed that individuals with MUNO and MUO were more likely to experience ischemic stroke compared with those with MHNO (OR 2.136, 95 % CI 1.677–2.720; OR 2.712, 95 % CI 1.798–4.092; all p < 0.001). The OR for ischemic stroke did not significantly differ between MHO and MHNO. Stratification based on different BMI group showed that, compared with people who were normal weight without Mes, participants who were in Mes with overweight or obesity had significantly higher OR for ischemic stroke(both p < 0.05); participants who were not in Mes with overweight or obesity did not showed OR significantly higher. Ischemic stroke is likely associated with poor metabolic health rather than with obesity itself.

Highlights

Obesity has been described as a major risk factor for metabolic complications, such as atherosclerosis and cardiovascular disease (CVD), as well as stroke (Van Gaal and Maggioni 2014; Danaei 2014; Mahmood et al 2014)
Baseline characteristics of participants according to different obesity phenotypes A total of 11,150 participants were evaluated in this cross-sectional study
Characteristics of participants with or without ischemic stroke The results presented in Table 2 show that the subjects with ischemic stroke were significantly older and had a significantly higher body mass index (BMI), waist circumference (WC), systolic blood pressure, diastolic blood pressure, and fasting plasma glucose, low-density lipoprotein cholesterol (LDL), total cholesterol (TC), and TG levels and a lower HDL level than those without stroke

Summary

Introduction

Obesity has been described as a major risk factor for metabolic complications, such as atherosclerosis and cardiovascular disease (CVD), as well as stroke (Van Gaal and Maggioni 2014; Danaei 2014; Mahmood et al 2014). A subset of obese individuals has been identified as metabolically healthy (MHO) (Yang et al 2015). Several studies have described MHO was an obese. MHO has been found to be a lower risk factor for coronary artery calcification, chronic kidney disease and heart failure (Chang et al 2014; Hosny et al 2014). Little is known about the effects of metabolically healthy and unhealthy obesity on stroke. Li et al SpringerPlus (2016) 5:1419 different obesity phenotype to ischemic stroke in a general population with the hypothesis different phenotype has different influence on stroke

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