Influence of obesity and diabetes on ischemic stroke

Objective To examine the association between different indicators of adiposity(body mass index BMI and wais-tto-hip ratioWHR),diabetes and the risk of ischemic stroke(IS).Methods A hospital-based case-control study was conducted.Cases(n=311)were patients ≥25 years old with ischemic stroke,who were admitted to Department of Neurology of First Affiliated Hospital and Third Affiliated Hospital of Liaoning Medical University,and Jinzhou Central Hospital between April 2011 to September 2012.Frequency-matched controls(n=311)were patients who had been admitted to the same hospital for diseases not related to stroke.All subjects were surveyed using a structured interviewer-administrated questionnaire and laboratory examinations.Results Multiple logistic regression analyses showed that compared to the controls with normal BMI,overweight and obesity were associated with a significantly increased risk for IS(odds ratio OR=1.571,95% confidence interval95%CI:1.0153-2.582,P=0.034;OR=1.775,95%CI:1.101-2.785,P=0.002,respectively).Compared to the controls in the lowest quartile,after adjusting for multiple potential confounders,the risk for IS in the highest quartile of WHR was increased by 36.0%(OR=1.360,95%CI:1.175-1.855,P=0.009).Compared to the controls in the lowest quartile,the OR for third and the highest quartile of fasting plasma glucose(FPG)were 1.566(95%CI:1.023-2.314,P=0.029)and 1.791(95%CI:1.159-2.725,P=0.018).Further multivariate logistic regression models showed that participants with diabetes had 2 times risk of IS as did the nondiabetic(OR=2.013,95%CI:1.245-2.987,P<0.001).Compared to the nondiabetic,the risk of IS in the participants with diabetes history <10 years and 10 to 20 years significantly increased(OR=2.264,95%CI:1.458-3.532,P=0.003;OR=2.317,95%CI:1.120-5.876,P=0.005,respectively).Conclusion Higher BMI,WHR,and diabetes were positively related to IS.Therefore,keeping normal weight and blood glucose may protect against IS.