The Role of Diabetes, Obesity, and Metabolic Syndrome in Stroke

Tang, Xiaowu Shirley; Liebeskind, David S; Towfighi, Amytis

doi:10.1055/s-0037-1603753

Cited by 16 publications

(11 citation statements)

References 72 publications

(52 reference statements)

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“…Several previous observational studies have investigated the association between obesity and risk of ischemic strokes . Both previous MR analyses suggested that obesity, but not BMI, could be causal in this relationship, showing an overall 30% increased risk for ischemic stroke for each standard deviation increase in abdominal adiposity .…”

Section: Discussionmentioning

confidence: 96%

Mendelian Randomization Study of Obesity and Cerebrovascular Disease

Marini

Merino

Montgomery

et al. 2020

Annals of Neurology

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Objective To systematically investigate causal relationships between obesity and cerebrovascular disease and the extent to which hypertension and hyperglycemia mediate the effect of obesity on cerebrovascular disease. Methods We used summary statistics from genome‐wide association studies for body mass index (BMI), waist‐to‐hip ratio (WHR), and multiple cerebrovascular disease phenotypes. We explored causal associations with 2‐sample Mendelian randomization (MR) accounting for genetic covariation between BMI and WHR, and we assessed what proportion of the association between obesity and cerebrovascular disease was mediated by systolic blood pressure (SBP) and blood glucose levels, respectively. Results Genetic predisposition to higher BMI did not increase the risk of cerebrovascular disease. In contrast, for each 10% increase in WHR there was a 75% increase (95% confidence interval [CI] = 44–113%) in risk for large artery ischemic stroke, a 57% (95% CI = 29–91%) increase in risk for small vessel ischemic stroke, a 197% increase (95% CI = 59–457%) in risk of intracerebral hemorrhage, and an increase in white matter hyperintensity volume (β = 0.11, 95% CI = 0.01–0.21). These WHR associations persisted after adjusting for genetic determinants of BMI. Approximately one‐tenth of the observed effect of WHR was mediated by SBP for ischemic stroke (proportion mediated: 12%, 95% CI = 4–20%), but no evidence of mediation was found for average blood glucose. Interpretation Abdominal adiposity may trigger causal pathological processes, partially independent from blood pressure and totally independent from glucose levels, that lead to cerebrovascular disease. Potential targets of these pathological processes could represent novel therapeutic opportunities for stroke. ANN NEUROL 2020;87:516–524

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Section: Discussionmentioning

confidence: 96%

Mendelian Randomization Study of Obesity and Cerebrovascular Disease

Marini

Merino

Montgomery

et al. 2020

Annals of Neurology

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“…The risk of bias was established through of a critical analysis of the studies selected using seven criteria for a methodological judgment supplied by the software Revman 5.3.0 program the Cochrane Handbook 23, developed for systematic reviews and available for free download (https://training.cochrane.org/online-learning/coresoftware-cochrane-reviews/revman/revman-5-download). Among the criteria that structure the bias assessment are (1) random sequence generation, (2) allocation concealment, (3) blinding of participants and personnel, (4) blinding of outcome assessment, (5) incomplete outcome data, (6) selective reporting, and (7) other bias.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…Increased consumption of unhealthy sugar, sodium, and fats, in addition to ultra-processed foods, including sugar-sweetened beverages and high-energy, nutrient-poor packaged foods have been strongly associated with weight gain and several nutrition-related non-communicable diseases ( 2 ). The high rate of obesity is associated with an increase in the development of some disease conditions such as systemic arterial hypertension ( 3 ), insulin resistance ( 4 ), and stroke ( 5 ). In addition to these conditions, obesity can affect physical parameters such as motor performance and gross motor coordination, as they seem to be directly related to regular physical activity and body composition in children and adolescents ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Overweight/Obesity on Motor Performance in Children: A Systematic Review

Barros

Silva²,

Silva³

et al. 2022

Front. Endocrinol.

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Childhood obesity is a serious public health problem. Childhood obesity and overweight are associated with the appearance of coordination deficit disorder and can cause impaired motor performance. We searched online databases for all related articles using comprehensive international databases from the Medline PubMed Institute, Web of Science, ScienceDirect, SCOPUS, and PsycINFO up to December 20, 2020. Overall, 33 studies were included in this systematic review. The present review demonstrated that children with higher percentage of body fat had lower levels of moderate to vigorous physical activity, as well as decreased levels of gross motor coordination, as shown by tests for neuromuscular performance. These results corroborate the hypothesis that overweight and obesity in children and adolescents are associated, not only with insufficient performance during gross motor coordination activities, but also with a greater risk to physical health.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42020182935].

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“…It also leads to a lack of oxygen to the body, oxidative stress, and chronic inflammation, causing blood vessel damage and extracellular matrix remodeling, such as pathological changes in vascular fibrosis (10,(13)(14)(15)(16). All of these are potential stroke triggers that can accelerate brain vessel damage (17,18). Observational studies have reported that obesity is associated with stroke, but the causality between them remains controversial (19,20).…”

Section: Introductionmentioning

confidence: 99%

Deciphering the Irregular Risk of Stroke Increased by Obesity Classes: A Stratified Mendelian Randomization Study

et al. 2021

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BackgroundTo investigate the relationship between different classes of obesity and stroke, we conducted a stratified Mendelian randomization (MR) study.MethodsThe body mass index (BMI) data of 263,407 Europeans with three classes of obesity (obesity class I, 30 kg/m2 ≤ BMI < 35 kg/m2; obesity class II, 35 kg/m2 ≤ BMI < 40 kg/m2; obesity class III, 40 kg/m2 ≤ BMI) were extracted from the Genetic Investigation of ANthropometric Traits (GIANT) consortium. Summary-level data of stroke and its subtypes [ischemic stroke (IS) and intracerebral hemorrhage (ICH)] were obtained from the genome-wide association study (GWAS) meta-analysis, which was performed by the MEGASTROKE consortium. MR methods were used to identify the causal relationships.ResultsThe MR analysis revealed that both obesity class I [odds ratio (OR) = 1.08, 95% CI: 1.05–1.12, p = 1.0 × 10-5] and obesity class II (OR = 1.06, 95% CI: 1.03–1.09, p = 1 × 10-4) were significantly positively related to IS, while obesity class III was not (OR = 1.01, 95% CI: 0.96–1.06, p = 0.65). In contrast to IS, there was no class of obesity associated with ICH risk. Further examination of the relationship between obesity classification and IS subtypes revealed that certain degrees of obesity were related to large artery stroke (LAS) (OR = 1.14, 95% CI: 1.04–1.24, p = 2.8 × 10-3 for class I; OR = 1.08, 95% CI: 1.01–1.16, p = 0.002 for class II) and cardioembolic stroke (CES) (OR = 1.11, 95% CI: 1.02–1.20, p = 0.02 for class I; OR = 1.08, 95% CI: 1.02–1.15, p = 0.007 for class II).ConclusionsA higher risk of IS, but not ICH, could be linked to obesity classes I and II. A strong association between LAS and CES and obesity was observed among all IS subtypes in the obese population.

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The Role of Diabetes, Obesity, and Metabolic Syndrome in Stroke

Cited by 16 publications

References 72 publications

Mendelian Randomization Study of Obesity and Cerebrovascular Disease

Mendelian Randomization Study of Obesity and Cerebrovascular Disease

Effects of Overweight/Obesity on Motor Performance in Children: A Systematic Review

Deciphering the Irregular Risk of Stroke Increased by Obesity Classes: A Stratified Mendelian Randomization Study

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