Central adiposity and mortality after first-ever acute ischemic stroke
Por:
Chiquete E., Ruiz-Sandoval J.L., Murillo-Bonilla L., León-Jiménez C., Ruiz-Madrigal B., Martínez-López E., Román S., Panduro A., Ramos A., Cantú-Brito C.
Publicada:
1 ene 2013
Resumen:
Background: The waist-to-height ratio (WHtR) may be a better adiposity measure than the body mass index (BMI). We evaluated the prognostic performance of WHtR in patients with acute ischemic stroke (AIS). Methods: First, we compared WHtR and BMI as adiposity measures in 712 healthy adults by tetrapolar bioimpedance analysis. Thereafter, baseline WHtR was analyzed as predictor of 12-month all-cause mortality in 821 Mexican mestizo adults with first-ever AIS by a Cox proportional hazards model adjusted for baseline predictors. Results: In healthy individuals, WHtR correlated higher than BMI with total fat mass and showed a higher accuracy in identifying a high percentage of body fat (p < 0.01). In AIS patients a U-shaped relationship was observed between baseline WHtR and mortality (fatality rate 29.1%). On multivariate analysis, baseline WHtR =0.300 or >0.800 independently predicted 12-month all-cause mortality (hazard ratio 1.91, 95% confidence interval 1.04-3.51). BMI was not associated with mortality, tested either as continuous, binomial or stratified variable. Conclusion: WHtR is a modifiable risk factor that accurately demonstrates body fat excess. Extreme WHtR values were associated with increased 12-month all-cause mortality in Mexican mestizo patients with AIS. No survival advantage was found with high WHtR as the pragmatic indicator of obesity in this population. Copyright © 2013 S. Karger AG, Basel.
Filiaciones:
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
Departments of Neurology, Mexico
Departments of Neurology, Facultad de Medicina, Universidad Autónoma de Guadalajara, Mexico
Department of Neurology, Hospital Valentín Gomez Farías, Zapopan, Mexico
Departments of Molecular Biology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Mexico
Department of Molecular Biology, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
Scientific Area, Sanofi-Aventis, Mexico City, Mexico
|