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http://ir.nhri.org.tw/handle/3990099045/10072
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| Title: | BMI and stroke mortality: Is there an obesity paradox among Asians? |
| Authors: | Wu, MH;Hsu, CY;Tsao, CK;Lu, PJ;Lee, JH;Tsai, SP;Wen, CP |
| Contributors: | Division of Health Services and Preventive Medicine |
| Abstract: | Background and Rationale: Overweight and obesity were progressively associated with increased ischemic stroke, in a meta-analysis pooling 25 studies. However, ‘obesity paradox’ was also reported for stroke in that obesity or overweight was protective of stroke. Across the spectrum of Body Mass Index (BMI), ‘who has the most risk’ remains unclear, when major risk factors were controlled. Methods: A large cohort from Taiwan, N = 469,088, successively recruited during 1994–2008 with comprehensive health screening data, was followed up with National Death file. Stroke risks for underweight (BMI <18.5), overweight (BMI25-29) and obesity (BMI ≥30) were expressed as hazard ratios (HR) by Cox model with BMI 23–24 as reference. Stroke as a whole or ischemic and hemorrhagic stroke separately were analyzed. Results: Underweight had the highest stroke mortality (HR = 1.90, 95% CI: 1.35–2.67), followed by next underweight with BMI at 18.5–22 (HR = 1.25, 95% CI: 1.03–1.52), while overweight (HR = 0.95, 95% CI: 0.78–1.16) and obesity (HR = 1.00, 95% CI: 0.70–1.43) showed no stroke increase. Among three age groups with underweight, age 40–64 had highest risk with HR = 2.71 (95% CI: 1.5–4.8). Significant results for underweight were similar for smokers (HR = 1.83, 95% CI: 1.02–3.27) or nonsmokers (HR = 2.03, 95% CI: 1.33–3.09), for hypertension (HR = 1.76; 95% CI: 1.13–2.72) or no hypertension (HR = 3.37; 95% CI: 1.88–6.06), and for ischemic stroke (HR: 1.82; 95% CI:1.15–2.89) or for hemorrhagic stroke (HR = 1.90: 95% CI: 1.15–3.14). Conclusion: In this large Asian cohort, for stroke mortality, all groups with underweight (BMI <18.5) had the highest risk, particularly at middle-aged adults (40–64). Obesity, defined as BMI ≥30, showed no increase in risk nor protective power against stroke. |
| Date: | 2016-07 |
| Relation: | Cerebrovascular Diseases. 2016 Jul;42(Suppl. 1):21. |
| Link to: | http://dx.doi.org/10.1159/000447732 |
| JIF/Ranking 2023: | http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1015-9770&DestApp=IC2JCR |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:000381107200042 |
| Appears in Collections: | [溫啟邦(2001-2010)] 會議論文/會議摘要
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| ISI000381107200042.pdf | | 112Kb | Adobe PDF | 423 | View/Open |
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