在急性缺血性中风后,体重和功能结果之间的非线性关联
Kayo Wakisaka1, Ryu Matsuo2,3, Koutarou Matsumoto4,5
1Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Scientific reports
|May 29, 2023
概括
体重影响中风恢复. 体重不足的人在缺血性中风后面临较高的不良结果风险,而超重患者的风险较低. 肥胖与中风的结果没有显著的关联.
科学领域:
- 神经学 神经学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 急性缺血性中风后的功能性结果是患者康复和生活质量的关键决定因素.
- 身体质量指数 (BMI) 是一种广泛用于分类体重的指标,包括体重不足,正常体重,超重和肥胖.
- 以前的研究已经产生了相互矛盾的结果,关于身体体重和中风结果之间的关联.
研究的目的:
- 调查身体质量指数 (BMI) 与急性缺血性中风后三个月的功能结果之间的关联.
- 探索不同BMI类别之间的非线性关系和功能性结果差的风险.
主要方法:
- 分析了一组11749名急性缺血性中风患者的队列.
- 体重指数 (BMI) 被分为体重不足 (<18.5公斤/米2),正常体重 (18.5-22.9公斤/米2),超重 (23.0-24.9公斤/米2) 和肥胖 (≥25.0公斤/米2).
- 后勤回归和机器学习模型 (eXtreme梯度提升与SHapley添加式扩展) 用于评估BMI和功能性结果差之间的关联 (修改的兰金尺度[mRS]得分:3-6).
主要成果:
- 与正常体重患者相比,体重不足患者的功能结果差的风险明显更高.
- 超重患者表现出较低的功能表现不佳的风险.
- 肥胖没有显示出与功能表现差的显著关联. 通过先进的统计建模证实了非线性关系.
- 即使不包括死亡率或包括轻度残疾作为结果,这些关联仍然是一致的,并且在老年,非糖尿病和轻度受影响的患者中特别强烈.
结论:
- 体重与急性缺血性中风后的功能结果有非线性关系.
- 体重不足和超重的状态都与功能表现不佳的风险发生变化有关,突出显示了超出简单体重类别的复杂性.
- 这些发现强调了在中风患者的管理和预后中考虑BMI的重要性,特别是在特定的子组中.
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