Comparison of metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients: a retrospective study

Abstract

Background Metabolic status and body mass index (BMI) are known as apparent risk factors of recurrent stroke, but which one is more likely related to recurrent stroke remains uncertain. This study aimed to compare the metabolic phenotypes and BMI as indicators of recurrent stroke in Chinese hospitalized stroke patients. Methods In this retrospective population-based study, 856 hospitalized stroke patients from the Third Affiliated Hospital of Soochow University were enrolled. Recurrent stroke was defined as newly-onset stroke patients with a history of previous stroke. Metabolic phenotypes were based on Adult Treatment Panel III criteria. BMI ≥ 25kg/m2 was defined as obesity. Results Among the hospitalized stroke patients, the prevalence of recurrent stroke was 21.9%. Metabolic phenotypes rather than BMI were significantly associated with recurrent stroke. Compared with metabolically healthy patients, metabolically unhealthy ones had 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.01–2.68) increased recurrent stroke, regardless of BMI and other confounding factors. Whereas, no statistical association between BMI and recurrent stroke were found. Metabolic status improved risk prediction of recurrent stroke when adding to conventional risk factors (net reclassification index 17.6%, P = 0.0047; integrated discrimination improvement 0.7%, P = 0.014), while BMI did not. Conclusions Recurrent stroke was likely associated with poor metabolic status rather than with BMI, suggesting that controlling metabolic abnormalities could be an important method for recurrent stroke prevention.