Key result
Among insulin-resistant patients with ischemic stroke, being overweight or obese was associated with a lower risk of 1-year mortality compared to low/normal weight (HR 0.50; 95% CI 0.31-0.82).
Why the study?
The underlying mechanisms of the stroke-obesity paradox remain incompletely understood, prompting investigation into the role of insulin resistance in the association between body mass index and stroke outcomes.
Does overweight/obesity improve 1-year mortality and functional outcomes in patients with ischemic stroke, and is this modified by insulin resistance?
Cohort (n=1,227)
Yes
Does overweight/obesity improve 1-year mortality and functional outcomes in patients with ischemic stroke, and is this modified by insulin resistance?
Hazard Ratio: 0.5 (95% CI 0.31–0.82)
Absolute Event Rate: 9.42% vs 17.69%
The obesity paradox for mortality and functional outcome after ischemic stroke is present in insulin-resistant patients but not in insulin-sensitive patients.
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Obesity paradox in post-stroke mortality may be limited to insulin-resistant patients; hypothesis-generating and requires prospective confirmation.
Xu et al. (2019) conducted a cohort in Ischemic stroke (n=1,227). Overweight or obesity (BMI ≥23) vs. Low/normal weight was evaluated on 1-year all-cause mortality in insulin-resistant patients (HR 0.50, 95% CI 0.31-0.82). Among insulin-resistant patients with ischemic stroke, being overweight or obese was associated with a lower risk of 1-year mortality compared to low/normal weight (HR 0.50; 95% CI 0.31-0.82).
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