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Body Mass Index and Prognosis in Ischemic Stroke Patients With Type 2 Diabetes Mellitus

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Author(s)
Hyungjong ParkHyung Woo LeeJoonsang YooHye Sun LeeHyo Suk NamYoung Dae KimJi Hoe Heo
Keimyung Author(s)
Yoo, Joon Sang
Department
Dept. of Neurology (신경과학)
Journal Title
Frontiers in Neurology
Issued Date
2019
Volume
10
Keyword
ischemic strokediabetes mellitusobesitybody mass indexmajor adverse cardiac eventmortality
Abstract
Background:
Overweight contributes to type 2 diabetes mellitus (T2DM) development. Although the obesity paradox has been suggested in many vascular diseases, little information is available about stroke patients with T2DM. We investigated whether body mass index (BMI) has a differential impact on the incidence of major adverse cardiovascular events (MACE) in patients with ischemic stroke and T2DM.

Methods:
This retrospective study used a prospective cohort of patients with acute ischemic stroke and included consecutive patients with T2DM after excluding those with active cancer or who died within 1 month of an index stroke. We investigated the long-term risk of MACE (stroke, myocardial infarction, unstable angina, coronary revascularization procedure, and death) according to BMI.

Results:
Among the 1,338 patients, MACE occurred in 415 patients (31.1%) during a median follow-up of 3.6 years. Compared to the normal weight group, MACE occurred more frequently in the underweight group [adjusted hazard ratio (HR) 1.55, 95% confidence interval (CI): 1.01–2.38], but less frequently in the overweight group (adjusted HR: 0.87, 95% CI: 0.70–1.08) and obese group (adjusted HR: 0.58, 95% CI: 0.41–0.86) group. In analyses of association between BMI and each component of MACE, stroke and cardiovascular mortality indicated an L- and a U-shaped pattern, respectively. However, fatal or non-fatal stroke showed an inverse pattern, and fatal or non-fatal cardiovascular events showed a reversed J-shaped pattern.

Discussions:
This study showed the overall presence of the obesity paradox in stroke patients with T2DM. However, obese patients had different risks of cardiovascular events and stroke.
Keimyung Author(s)(Kor)
유준상
Publisher
School of Medicine (의과대학)
Citation
Hyungjong Park et al. (2019). Body Mass Index and Prognosis in Ischemic Stroke Patients With Type 2 Diabetes Mellitus. Frontiers in Neurology, 10. doi: 10.3389/fneur.2019.00563
Type
Article
ISSN
1664-2295
Source
https://www.frontiersin.org/articles/10.3389/fneur.2019.00563/full
DOI
10.3389/fneur.2019.00563
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42041
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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