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A Nonlinear Relation between Body Mass Index and Long-Term Poststroke Functional Outcome-The Importance of Insulin Resistance, Inflammation, and Insulin-like Growth Factor-Binding Protein-1.
Gadd, Gustaf; Åberg, Daniel; Wall, Alexander; Zetterberg, Henrik; Blennow, Kaj; Jood, Katarina; Jern, Christina; Isgaard, Jörgen; Svensson, Johan; Åberg, N David.
Afiliación
  • Gadd G; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
  • Åberg D; Region Västra Götaland, Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
  • Wall A; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
  • Zetterberg H; Region Västra Götaland, Department of Specialist Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden.
  • Blennow K; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
  • Jood K; Närhälsan, Region Västra Götaland, 411 04 Gothenburg, Sweden.
  • Jern C; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden.
  • Isgaard J; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 431 41 Mölndal, Sweden.
  • Svensson J; Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK.
  • Åberg ND; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China.
Int J Mol Sci ; 25(9)2024 Apr 30.
Article en En | MEDLINE | ID: mdl-38732147
ABSTRACT
Both high serum insulin-like growth factor-binding protein-1 (s-IGFBP-1) and insulin resistance (IR) are associated with poor functional outcome poststroke, whereas overweight body mass index (BMI; 25-30) is related to fewer deaths and favorable functional outcome in a phenomenon labeled "the obesity paradox". Furthermore, IGFBP-1 is inversely related to BMI, in contrast to the linear relation between IR and BMI. Here, we investigated s-IGFBP-1 and IR concerning BMI and 7-year poststroke functional outcome. We included 451 stroke patients from the Sahlgrenska Study on Ischemic Stroke (SAHLSIS) with baseline measurements of s-IGFBP1, homeostasis model assessment of IR (HOMA-IR), BMI (categories normal-weight (8.5-25), overweight (25-30), and obesity (>30)), and high-sensitivity C-reactive protein (hs-CRP) as a measure of general inflammation. Associations with poor functional outcome (modified Rankin scale [mRS] score 3-6) after 7 years were evaluated using multivariable binary logistic regression, with overweight as reference due to the nonlinear relationship. Both normal-weight (odds-ratio [OR] 2.32, 95% confidence interval [CI] 1.30-4.14) and obese (OR 2.25, 95% CI 1.08-4.71) patients had an increased risk of poor functional outcome, driven by deaths only in the normal-weight. In normal-weight, s-IGFBP-1 modestly attenuated (8.3%) this association. In the obese, the association was instead attenuated by HOMA-IR (22.4%) and hs-CRP (10.4%). Thus, a nonlinear relation between BMI and poor 7-year functional outcome was differently attenuated in the normal-weight and the obese.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Resistencia a la Insulina / Índice de Masa Corporal / Proteína 1 de Unión a Factor de Crecimiento Similar a la Insulina / Inflamación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Resistencia a la Insulina / Índice de Masa Corporal / Proteína 1 de Unión a Factor de Crecimiento Similar a la Insulina / Inflamación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Mol Sci Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza