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Obesity-stroke paradox and initial neurological severity
Yerim Kim1, Chi Kyung Kim1, Seunguk Jung1
1Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
Journal of Neurology, Neurosurgery, and Psychiatry
|September 12, 2014
Summary
Obesity may be linked to better short-term outcomes after ischemic stroke. However, initial neurological severity is a more critical prognostic factor. Further research should consider initial status when examining the obesity paradox.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- The obesity paradox, where higher body mass index (BMI) is associated with better outcomes in certain diseases, has been observed in stroke patients.
- Previous studies often overlooked the impact of initial neurological severity (INS) on this paradox.
Purpose of the Study:
- To investigate the relationship between obesity and INS in patients with ischemic stroke.
- To determine if obesity is a significant risk factor for short-term outcomes following ischemic stroke.
Main Methods:
- A cohort of 2670 ischemic stroke patients from Seoul National University Hospital (October 2002 - May 2013) was analyzed.
- Baseline data, including BMI and INS, were collected upon admission.
- Associations between BMI and INS, and the effect of BMI on 3-month modified Rankin Scale (mRS) scores were evaluated.
Main Results:
- Higher BMI levels were associated with reduced risks of moderate to severe INS.
- Patients with higher BMI showed more favorable 3-month mRS outcomes.
- These associations became non-significant after adjusting for INS.
Conclusions:
- While obesity showed an association with better short-term functional outcomes in ischemic stroke patients, INS emerged as a more significant prognostic factor.
- The 'obesity paradox' in stroke requires consideration of the patient's initial neurological status.
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