Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood

Bardugo, Aya; Fishman, Boris; Libruder, Carmit; Tanné, David; Ram, Amit; Hershkovitz, Yael; Zucker, Inbar; Furer, Ariel; Gilon, Roy; Chodick, Gabriel; Tiosano, Shmuel; Derazne, Estela; Tzur, Dorit; Afek, Arnon; Pinhas‐Hamiel, Orit; Bendor, Cole D.; Gal, Yaniv; Rotem, Ran; Twig, Gilad

doi:10.1161/strokeaha.120.033595

Cited by 27 publications

(27 citation statements)

References 39 publications

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“…A population-based case–control study including 1,201 patients with ischemic stroke and 1154 controls aged 15–49 years showed that obesity defined as BMI > 30 kg/m 2 was associated with an increased risk (odds ratio, 1.57; 95% CI, 1.28–1.94) [ 29 ]. Additionally, a higher BMI in adolescents was associated with a greater risk of ischemic stroke [ 30 ]. The analysis of the Atherosclerosis Risk in Communities (ARIC) Study including approximately 13,000 black and white people showed that obesity was associated with a greater risk of ischemic stroke irrespective of race [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

et al. 2021

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Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m2). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2), or obese (BMI ≥ 30 kg/m2). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.

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Section: Discussionmentioning

confidence: 99%

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

et al. 2021

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“…There have been many findings in the past suggesting that elevated BMI is associated with a higher risk of ischemic stroke (36)(37)(38)(39). However, the relationship between BMI and the prognosis of stroke patients is uncertain and controversial.…”

Section: Discussionmentioning

confidence: 99%

Body mass index has a non-linear association with three-month outcomes in men with acute ischemic stroke: An analysis based on data from a prospective cohort study

Zan

Xiong

Zhang³

et al. 2022

Front. Endocrinol.

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ObjectiveDespite reports of a connection between body mass index (BMI) and stroke outcome, the findings remain debatable. In this investigation, we sought to determine whether BMI was associated with the probability of 3-month unfavorable outcomes in patients with acute ischemic stroke (AIS).MethodsThis is a second analysis based on a cohort study. 1,897 people with AIS who were treated at a hospital in South Korea from January 2010 to December 2016 were included in the study. The linear relationship between BMI and unfavorable outcomes for AIS patients was evaluated using a binary logistic regression model. The generalized additive model (GAM) and smoothed curve fitting (penalized spline approach) were employed to see if there was a non-linear association between BMI and unfavorable outcomes in patients with AIS.ResultsThe binary logistic regression model did not detect any statistically significant correlation between BMI and unfavorable outcomes in AIS patients after controlling for variables. The association between them, however, was non-linear, with the BMI inflection point occurring at 23.07 kg/m2. Each 1 kg/m2 rise in BMI on the left side of the inflection point was linked to a 12% lower risk of unfavorable outcomes (OR= 0.88, 95% CI: 0.82 to 0.96, p = 0.003). We stratified the AIS patients by gender to further explore their relationship. The results showed a specific non-linear relationship and saturation effect of BMI (kg/m2) with 3-month unfavorable outcomes in male patients but not in female patients. The inflection point for BMI was 23.35 kg/m2. When BMI was below 23.35 kg/m2 in men with AIS, BMI was inversely associated with unfavorable outcomes (OR=0.89,95% CI:0.80-0.98).ConclusionA particular non-linear connection and saturation effect between BMI (kg/m2) and 3-month unfavorable outcomes were present in male patients with AIS but not in females. 23.35 kg/m2 was the BMI’s inflection point. The probability of unfavorable outcomes was substantially and inversely associated with BMI in men with AIS when it was less than 23.35 kg/m2. Men with AIS should have a BMI of no less than 23.35 kg/m2 to reduce the probability of unfavorable outcomes following AIS.

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“…Investigations into obesity have yielded contrasting results. Some recent evidence suggests that obesity portends greater risks of IS within the young adult population with increasing body mass index yielding incremental increases in IS hazard [53][54][55]. However, other studies have found no significant association between obesity and stroke risk after controlling for other pertinent variables [55].…”

Section: Modifiable Risk Factorsmentioning

confidence: 99%

A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke

Potter

Tannous

Vahidy

2022

Curr Atheroscler Rep

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Purpose of Review Recent data identifies increases in young ischemic and hemorrhagic strokes. We provide a contemporary overview of current literature on stroke among young patients or premature stroke along with directions for future investigation. Recent Findings Strokes in the young are highly heterogenous and often cryptogenic. Sex distribution and risk factors shift from women among the youngest age groups (< 35) to men over the age of 45, with a coinciding rise in traditional vascular risk factors. Incidence is higher in minority and socioeconomically disadvantaged populations, and the impact of stroke among these communities may be exaggerated by disparities in symptom recognition and access to care. Special diagnostic work-up may be needed, and a lower threshold for diagnosis is warranted as potential misdiagnosis is a concern and may preclude necessary triage and management. Summary Although “premature strokes” form a relatively small proportion of total incidence, they vary greatly across subgroups and present an outsized impact on quality of life and productivity.

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Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood

Cited by 27 publications

References 39 publications

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Body mass index has a non-linear association with three-month outcomes in men with acute ischemic stroke: An analysis based on data from a prospective cohort study

A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke

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