Obesity and Risk for First Ischemic Stroke Depends on Metabolic Syndrome: The HUNT Study

医学 代谢综合征 超重 危险系数 肥胖 内科学 体质指数 冲程(发动机) 比例危险模型 前瞻性队列研究 糖尿病 风险因素 物理疗法 腰围 内分泌学 置信区间 工程类 机械工程
作者
Jan-Tore H. Horn,Tao Feng,Bjørn Mørkedal,Linn Beate Strand,Julie Horn,Kenneth J. Mukamal,Imre Janszky
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:52 (11): 3555-3561 被引量:23
标识
DOI:10.1161/strokeaha.120.033016
摘要

Obesity is one of the most prevalent modifiable risk factors of ischemic stroke. However, it is still unclear whether obesity itself or the metabolic abnormalities due to obesity increase the risk of ischemic stroke. We therefore investigated the association between metabolic health, weight, and risk of ischemic stroke in a large prospective cohort study.In the Norwegian HUNT study (Trøndelag Health Study), we included 35 105 participants with complete information on metabolic risk factors and relevant covariates. Metabolically unhealthy state was defined as sex specific increased waist circumference in addition to 2 or more of the following criteria: hypertension, increased blood pressure, decreased high-density lipoprotein, triglycerides or glucose, or self-reported diagnosis of diabetes. We then applied Cox proportional hazard models to estimate the risk for ischemic stroke among overweight and obese metabolically healthy and unhealthy participants compared with metabolically healthy, normal weight participants.A total of 1161 ischemic stroke cases occurred after an average observation time of 11.9 years. In general, metabolically unhealthy participants were at increased risk of ischemic stroke (for obese participants: hazard ratio, 1.30 [95% CI, 1.09–1.56] compared with metabolically healthy participants with a normal body mass index). Hypertension appeared to be the most important metabolic risk factor. Metabolically healthy participants with overweight or obesity were at similar risk of ischemic stroke compared with normal weight participants (hazard ratio, 1.02 [95% CI, 0.81–1.28] for participants with obesity). Obesity and overweight even over an extended period of time seems to be benign about ischemic stroke, as long as it was not associated with metabolic abnormalities.Obesity was not an independent ischemic stroke risk factor in this cohort, and the risk depended more on the metabolic consequences of obesity.
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