Adiposity and domain-specific stroke recovery: A Mendelian randomization study

Area of Science:

• Genetics and Epidemiology
• Neurology and Stroke Recovery

Background:

• Adiposity is a known risk factor for ischemic stroke incidence.
• The impact of adiposity on functional recovery after stroke remains unclear.

Purpose of the Study:

• To investigate the causal effects of body mass index (BMI) and waist-to-hip ratio (WHR) on post-stroke recovery.
• To examine the influence of adiposity on motor, cognitive, and global functional recovery using Mendelian randomization.

Main Methods:

• Utilized Mendelian randomization (MR) with genetic proxies for BMI and WHR from large genome-wide association studies (GWAS).
• Assessed longitudinal recovery trajectories using National Institutes of Health Stroke Scale (NIHSS) measures over two years.
• Employed the inverse-variance weighted method for MR effect estimation in the VISP trial cohort.

Main Results:

• A 1-SD increase in genetically predicted BMI was associated with significantly lower odds of motor recovery (OR=0.37, p=0.003).
• Genetically predicted BMI also correlated with worse cognitive (β=-0.12, p=0.009) and global recovery (β=-0.36, p=0.002).
• No statistically significant associations were found between genetically predicted WHR and post-stroke recovery outcomes.

Conclusions:

• Human genetic evidence indicates that higher adiposity negatively affects multiple aspects of post-stroke recovery, including motor function and cognition.
• Further research is needed to elucidate the biological pathways linking adiposity to impaired stroke recovery.