Visceral Adiposity and Risk of Stroke: A Mendelian Randomization Study

Ren, Xu; Hu, Xinzhi; Wang, Tao; Yang, Yutong; Nan, Jiang; Luo, Jichang; Zhang, Xiao; Dmytriw, Adam A.

doi:10.3389/fneur.2022.804851

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…Visceral adipose tissue is essential for energy and nutritional metabolism. A recent Mendelian randomization study [ 49 ] provided potential evidence for a causal role of visceral adipose tissue in new-onset stroke. However, it also releases inflammatory cytokines and chemokine mediators that contribute to the formation of carotid plaques and elevate the likelihood of new-onset stroke [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study

et al. 2023

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Background Stroke represents the second most prevalent contributor to global mortality. The Chinese Visceral Adiposity Index (CVAI) serves as an established metric for assessing visceral adiposity in the Chinese population, exhibiting prognostic capabilities. This investigation aimed to explore the association of CVAI and new-onset stroke among middle-aged and older Chinese populations. Methods The study employed data from the 2011 and 2018 China Health and Retirement Longitudinal Study (CHARLS) to assess the association of CVAI and the incidence of new-onset stroke. Utilizing a directed acyclic graph (DAG), 10 potential confounders were identified. Moreover, to explore the association between CVAI and new-onset stroke, three multifactor logistic regression models were constructed, accounting for the identified confounders and mitigating their influence on the findings. Results The study comprised 7070 participants, among whom 417 (5.9%) experienced new-onset strokes. After controlling for confounding variables, regression analysis suggested that the new-onset stroke’s highest risk was linked to the fourth quartile (Q4) of the CVAI, with an odds ratio (OR) of 2.33 and a 95% confidence interval (CI) of 1.67–3.28. The decision tree analysis demonstrated a heightened probability of new-onset stroke among hypertensive individuals with a CVAI equal to or greater than 83, coupled with a C-reactive protein level no less than 1.1 mg/l. Age seemed to have a moderating influence on the CVAI and new-onset stroke association, exhibiting a more prominent interaction effect in participants under 60 years. Conclusions In middle-aged and older Chinese populations, a linear relationship was discerned between CVAI and the probability of new-onset stroke. CVAI provides a predictive framework for stroke incidence in this demographic, laying the groundwork for more sophisticated risk prediction models that improve the precision and specificity of stroke risk evaluations.

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Section: Discussionmentioning

confidence: 99%

Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study

et al. 2023

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“…Meanwhile, we found both TC and blood sugar levels had a statistically significant association with neurological outcome, regardless of patients with previous history of DM or hypertension. Metabolic syndrome is a risk factor for the poor outcome in stroke ( Xu et al, 2022 ). After reducing the risk factors, most stroke patients might have a better prognosis after thrombolysis, while some of them might be not.…”

Section: Discussionmentioning

confidence: 99%

Prognostic nomogram for the outcomes in acute stroke patients with intravenous thrombolysis

Zheng

Qiuyun

et al. 2022

Front. Neurosci.

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Background and purposeThe prediction of neurological outcomes in ischemic stroke patients is very useful in treatment choices, as well as in post-stroke management. This study is to develop a convenient nomogram for the bedside evaluation of stroke patients with intravenous thrombolysis.Materials and methodsWe reviewed all enrolled stroke patients with intravenous thrombolysis retrospectively. Favorable outcome was defined as modified Rankin Score (mRs) less than 2 at 90 days post thrombolysis. We compared the clinical characteristics between patients with favorable outcome and poor outcome. Then, we applied logistic regression models and compared their predictability.ResultsA total of 918 patients were enrolled in this study, 448 patients from one hospital were included to develop a nomogram, whereas 470 patients from the other hospital were used for the external validation. Associated risk factors were identified by multivariate logistic regression. The nomogram was validated by the area under the receiver operating characteristic curve (AUC). A nomogram was developed with baseline NIHSS, blood sugar, blood cholesterol level, part-and full anterior circulation infarction (OCSP type). The AUC was 0.767 (95% CI 0.653–0.772) and 0.836 (95% CI 0.697–0.847) in the derivation and external validation cohorts, respectively. The calibration plot for the probability of severe neurological outcome showed an optimal agreement between the prediction by nomogram and actual observation in both derivation and validation cohorts.ConclusionA convenient outcome evaluation nomogram for patients with intravenous thrombolysis was developed, which could be used by physicians in making clinical decisions and predicting patients’ prognosis.

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“…The study conducted by Huang et al demonstrated significant correlations between VAT mass and a wide range of CVD outcomes, including but not limited to coronary heart disease, cardiac arrhythmia, vascular diseases, and stroke (16). Additionally, another Mendelian Randomization Study furnished proof of a substantial causal link between VAT and ischemic stroke, as opposed to intracerebral hemorrhage (17). In general, visceral obesity is among the most evident clinical features of MetS (18).…”

Section: Introductionmentioning

confidence: 99%

Elevated Chinese visceral adiposity index increases the risk of stroke in Chinese patients with metabolic syndrome

Liu

Huang

et al. 2023

Front. Endocrinol.

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IntroductionPatients with Metabolic Syndrome (MetS) are considered at high-risk for incident stroke. An indicator of visceral adiposity dysfunction, the Chinese Visceral Adiposity Index (CVAI) is used to evaluate the dysfunction of visceral fat. Given the impact of visceral adiposity dysfunction on elevating cardiovascular hazards, this study aimed to examine the association between CVAI and stroke risk in MetS patients.MethodBetween November 2017 and December 2018, a total of 18,974 individuals aged ≥40 underwent standardized in-person clinical interviews in Hunan Province, with 6,732 meeting the criteria for MetS. After the baseline survey was completed, subsequent surveys were conducted biennially. The study was split into two stages performed at baseline and after two years. During the former, receiver-operating characteristic curves were used to assess the accuracy of using baseline CVAI in diagnosing MetS. After two years, we examined the association between CVAI and incident stroke in MetS patients using logistic regression, subgroup analysis, and restricted cubic spline (RCS) analysis.ResultAs evidenced by a higher AUC (AUC:0.741), CVAI demonstrated superior diagnostic performance relative to body mass index (AUC:0.631) and waist circumference (AUC:0.627) in diagnosing MetS. After a 2-year follow-up, 72 MetS patients had a stroke event. There was a robust positive correlation between incident stroke and CVAI in patients with MetS. Each 1 SD increase in CVAI was associated with a 1.52-fold higher risk of stroke after adjustment for confounding factors (aOR=1.52, 95%CI: 1.18-1.95). The RCS demonstrated a reduced risk of stroke for MetS patients when the CVAI was below 110.91. However, no significant correlation was detected between CVAI and stroke in non-MetS patients.ConclusionOur findings recommend CVAI as a superior screening tool for detecting MetS and suggest that reducing CVAI can mitigate the risk of stroke in patients with MetS.

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Visceral Adiposity and Risk of Stroke: A Mendelian Randomization Study

Cited by 8 publications

References 27 publications

Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study

Associations of Chinese visceral adiposity index and new-onset stroke in middle-aged and older Chinese adults: an observational study

Prognostic nomogram for the outcomes in acute stroke patients with intravenous thrombolysis

Elevated Chinese visceral adiposity index increases the risk of stroke in Chinese patients with metabolic syndrome

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