重温肥胖悖论:BMI和WHR与功能性结果的中风亚型特定关联
Cerebrovascular diseases extra
|December 1, 2025
概括
肥胖对中风预后的影响是复杂的. 腰比 (WHR) 是比体重指数 (BMI) 更好的预测指标,特别是与BMI相结合时,可以更好地预测中风的结果.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 肥胖是已知的缺血性中风风险因素,但其预后影响尚不清楚.
- 本研究研究了身体质量指数 (BMI) 和腰比 (WHR) 对早期中风结果的独立和联合影响.
研究的目的:
- 确定急性缺血性中风或短暂缺血性发作 (TIA) 患者的BMI和WHR的预后值.
- 分析这些脂肪测量与不同中风亚型中风严重程度和功能结果的关联.
主要方法:
- 714名急性缺血性中风或TIA患者的前性队列研究.
- 在入院时评估BMI和WHR,记录中风严重程度 (NIHSS) 和功能结果 (mRS).
- 应用多变量回归和受限立方线模型进行分析,包括TOAST和ESUS标准用于病因分类.
主要成果:
- 在BMI和中风结果之间观察到一个U形的关联;超重的个体 (BMI25.0-29.9 kg/m2) 有最好的结果.
- 体重不足和肥胖的患者经历了明显更糟糕的结果 (p < 0.001).
- WHR独立预测了较高的中风严重程度和较差的结果,并与BMI结合时增加了预后价值,在女性中显著的性别特异性益处.
结论:
- BMI和WHR表现出与中风严重程度和结果的明显,非线性,性别和亚型特定的关联.
- 在预后能力方面,WHR超过了BMI,并且在与BMI结合使用时改善了预测.
- 这些发现挑战了"肥胖悖论",并主张将肥胖现象类型纳入个性化中风风险模型.
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