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Adiposity and Functional Outcome After Ischemic Stroke: A Mendelian Randomization Study

Mengmeng Wang¹, Zhizhong Zhang¹, Iyas Daghlas¹

¹From the Department of Neurology (M.W., X.L.), The Third Affiliated Hospital of Soochow University, Changzhou, China; Department of Neurology (Z.Z.), Jinling Hospital, Medical School of Nanjing University, China; Department of Neurology (I.D.), University of California San Francisco; Department of Epidemiology and Biostatistics (D.G.), School of Public Health, St Mary's Hospital, Imperial College London, United Kingdom; and Department of Integrated Traditional Chinese and Western Medicine (D.L.), The Third Affiliated Hospital of Soochow University, Changzhou, China.

|January 5, 2024

Summary

Abdominal adiposity, measured by waist-to-hip ratio, is linked to poor functional recovery after ischemic stroke. Body mass index, however, showed no such association in this genetic study.

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Area of Science:

Genetics
Epidemiology
Neurology

Background:

Investigating the causal link between adiposity and post-stroke functional outcomes is crucial for understanding recovery.
Abdominal adiposity (waist-to-hip ratio, WHR) and overall adiposity (body mass index, BMI) are key areas of interest.

Approach:

Utilized Mendelian randomization to assess causal relationships between WHR, BMI, and ischemic stroke functional outcome.
Employed large-scale genome-wide association study data for genetic instruments and extracted outcome data from a relevant network.
Analyzed functional outcome using the modified Rankin Scale (mRS) at 3 months post-stroke.

Key Points:

Genetically predicted higher WHR was significantly associated with unfavorable functional outcome (mRS 3-6) after ischemic stroke.
Genetically predicted BMI did not show a significant association with unfavorable functional outcome post-stroke.
Sensitivity analyses confirmed the directional consistency of the WHR findings.

Conclusions:

This study provides genetic evidence that abdominal adiposity negatively impacts functional recovery following ischemic stroke.
Findings suggest targeting abdominal fat may be beneficial for improving stroke outcomes.