Adiposity and Functional Outcome After Ischemic Stroke

 This means that your doctor has more work to do to get you 100% recovered if you have this issue. Don't let your doctor off the hook of 100% recovery by quoting the craptastic saying: 'All strokes are different, all stroke recoveries are different'. If you hear that fire them and find a better doctor

Adiposity and Functional Outcome After Ischemic Stroke

A Mendelian Randomization Study

Mengmeng Wang, MD https://orcid.org/0000-0002-9890-8900, Zhizhong Zhang, PhD, Iyas Daghlas, MD https://orcid.org/0000-0001-6924-0641, Dipender Gill, MD, PhD https://orcid.org/0000-0001-7312-7078, Dandan Liu, MD, and Xuegan Lian, PhDAuthors Info & Affiliations

February 13, 2024 issue

102 (3)

https://doi.org/10.1212/WNL.0000000000208080

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Abstract

Background and Objectives

To investigate the causal relationships of abdominal adiposity (waist-to-hip ratio [WHR]) and overall adiposity (body mass index [BMI]) with functional outcome after ischemic stroke using Mendelian randomization.

Methods

Genetic instruments for WHR and BMI were obtained from the largest available genome-wide association studies meta-analysis of the Genetic Investigation of ANthropometric Traits consortium and the UK Biobank (N max = 806,834). Functional outcome after ischemic stroke was assessed using the modified Rankin Scale (mRS) score at 3-month after stroke onset, with mRS >2 (mRS 3–6) defined as an unfavorable functional outcome. Corresponding genetic estimates for an unfavorable functional outcome were extracted from the Genetics of Ischemic Stroke Functional Outcome network (N = 6,021). We applied a random-effects inverse variance weighted method as our main analysis.

Results

Genetically predicted higher WHR (per 0.09 ratio units) was associated with unfavorable functional outcome after ischemic stroke (mRS 3–6, OR = 1.48; 95% CI = 1.03–2.13; p = 0.033). The results remained directionally consistent in sensitivity analyses. Conversely, genetically predicted BMI (per 4.8 kg/m²) was not associated with unfavorable functional outcome after ischemic stroke (OR = 1.01; 95% CI = 0.75–1.36; p = 0.937).

Discussion

This study provides genetic evidence supporting the hypothesis that abdominal adiposity has a detrimental effect on functional recovery after ischemic stroke.