| Abstract: | Background and Rationale: Obesity paradox shows that obesity and overweight are associated with increased stroke risk but reduced mortality and favorable functional outcomes in acute ischemic stroke patients. We aimed to test the age effect on the obesity paradox in functional outcome after acute ischemic stroke. Methods: With the data from the Taiwan Stroke Registry (TSR), patients of acute ischemic stroke were categorized with body mass index (BMI) as underweight (BMI <18.5), normal weight (BMI 18.5–22.9), overweight (BMI 23–27.4), and obese (BMI ≥27.5 kg/m 2 ) and divided into four age groups (20–44, 45–64, 65–74, and ≥75 years). Functional outcome was defined with modified Rankin Scale (mRS) with 0–2 as favorable and 3–5 as unfavorable, and measured 3 and 6 months after acute ischemic stroke.Results: Totally there were 26955 patients recruited for analysis. As compared within four BMI categories, overweight patients had the most favorable outcome at 3 and 6 months (OR, 0.90; 95% CI, 0.82–0.99, and 0.90; 95% CI, 0.82–0.99), while underweight patients had the worst outcome at 3 and 6 months (OR, 1.65; 95% CI, 1.34–2.04, and 1.72; 95% CI, 1.38–2.14). After stratification by age, only overweight patients with the age over 75 years had the most favorable outcome 3 and 6 months (OR, 0.86; 95% CI, 0.74–0.99, and 0.82; 95% CI, 0.70–0.95), while underweight patients had the worst functional outcome with the age over 45 years. Overweight patients with the age under 75 years or obese patients with any age group did not show better functional outcome than those with normal weight.Conclusion: In consideration of age effect on obesity paradox, only the overweight aged patients have better short-term and mid-term functional outcomes than those with normal weight after acute ischemic stroke. Underweight patients sustain the most worst functional outcome among four BMI categories. |
