Effect of body mass index and abdominal girth index on location and etiology of ischemic stroke

Abstract

Objective To investigate the influence of body mass index (BMI) and abdominal girth index (AGI) on the location and etiology of ischemic stroke in order to determine whether they can predict the etiology and pathogenesis of ischemic stroke.  Methods A total of 185 patients with acute ischemic stroke and 155 cases of normal controls matched in sex, age and past medical history were enrolled in this study. Their height and weight were measured to calculate BMI, and abdominal circumference was measured to calculate AGI. Oxfordshire Community Stroke Project (OCSP) and TOAST classification were carried out. Results BMI of overweight (BMI 24.00-27.90 kg/m²) subgroup (t = 2.060, P = 0.000) and obesity (BMI ≥ 28 kg/m²) subgroup (t = 2.315, P = 0.000) in patients with ischemic stroke was significantly higher than that in control group. AGI of abnomaly (AGI > 1 cm/kg) subgroup in patients with ischemic stroke was significantly higher than that in control group (t = 1.021, P = 0.000). Based on OCSP classification, 185 patients with ischemic stroke were classified into 10 (5.41%) of total anterior circulation infarct (TACI), 81 (43.78%) of partial anterior circulation infarct (PACI), 56 (30.27%) of lacunar infarct (LACI) and 38 (20.54%) of posterior circulation infarct (POCI). Only the PACI ratio among different BMI subgroups had statistical significance (H = 7.041, P = 0.011). PACI ratio in BMI 24.00-27.90 kg/m² subgroup was significantly higher than that in BMI < 18.50 kg/m² subgroup (Z = 4.823, P = 0.028), 18.50-23.90 kg/m² subgroup (Z = 3.157, P = 0.026) and ≥ 28 kg/m² subgroup (Z = 2.076, P = 0.015). In AGI subgroups, only POCI ratio in AGI ＞1 cm/kg subgroup was significantly higher than that in AGI ≤ 1 cm/kg subgroup (χ² = 6.624, P = 0.010). In TOAST classification, 185 patients with ischemic stroke were classified into 59 (31.89%) of large artery atherosclerosis (LAA), 57 (30.81%) of small artery occlusion (SAO), 32 (17.30%) of cardioembolism (CE), 17 (9.19%) of stroke of other determined etiology (SOE) and 20 (10.81%) of stroke of undetermined etiology (SUE). LAA ratio (H = 21.597, P = 0.000) and SAO ratio (H = 29.908, P = 0.000) among different BMI subgroups had statistical significance. LAA ratio in BMI ≥ 28 kg/m2 subgroup was significantly higher than that in < 18.50 kg/m² subgroup (Z = 9.263, P = 0.020), 18.50-23.90 kg/m² subgroup (Z = 18.780, P = 0.000) and 24.00-27.90 kg/m2 subgroup (Z = 6.817, P = 0.009). SAO ratio in BMI 18.50-23.90 kg/m² subgroup was significantly higher than that in < 18.50 kg/m² subgroup (Z = 7.404, P = 0.007), 24.00-27.90 kg/m² subgroup (Z = 22.849, P = 0.000) and ≥ 28 kg/m² subgroup (Z = 12.025, P = 0.001). In AGI subgroups, LAA ratio in > 1 cm/kg subgroup was significantly higher (χ² = 11.461, P = 0.001), while SOE ratio was significantly lower ( χ² = 4.558, P = 0.033) than that in AGI ≤ 1 cm/kg subgroup.  Conclusions BMI and AGI can influence the location and etiology of ischemic stroke, which can be used to predict the etiology and pathogenesis of ischemic stroke.

DOI: 10.3969/j.issn.1672-6731.2017.11.011