Table 4.
List of studies on the association between obesity and stroke outcomes
| References | Design | Number of participants | Main Results |
|---|---|---|---|
| Liu Z et al. 2021 [18] | Placebo-controlled, randomized clinical trial | 1033 | BMI is inversely associated with short-term mortality, and U-shaped or J-shaped with short-term functional outcomes |
| Oesch L et al. 2017 [19] | Twenty-five studies, non-randomized studies | 299,750 |
One study showed the association between WHtR and mortality was U-shaped BMI and mortality after stroke: ten of twelve studies support the existence of an obesity paradox BMI and non-fatal outcome: seven of nine studies reported the association between higher body weight and improved non-fatal outcomes |
| Rozen G et al. 2022 [20] | Real-world national cohort | 84,185 | Inverse association between BMI and in-hospital mortality |
| Aparicio HJ et al. 2017 [14] | Nested case–control study | 782 (stroke patients) | Overweight and low obese patients but not high obese patients had reduced 10-year mortality |
| Akyea RK et al. 2021 [21] | A prospective cohort study | 30,702 | Overweight or obesity was associated with better long-term outcomes, including lower risk of major adverse cardiovascular events and mortality |
| Jang SY et al. 2015 [22] | A nested case study within a prospective nationwide cohort | 2057 | Extreme obesity (BMI > 30 kg/m2) is associated with short-term good functional outcomes, especially for the young |
| Pirson FAV et al. 2019 [23] | A post hoc analysis of a national randomized trial for acute ischemic stroke | 366 |
Higher BMI was associated with better short-term prognosis, including improved functional outcome, reduced mortality for large vessel occlusion patients BMI did not affect endovascular treatment effect |
| Freeman C et al. 2022 [24] | Retrospective cohort study | 392 | The association between higher BMI and functional gains was affected by age, motor function on admission and diabetes |
| Scherbakov N et al. 2011 [25] | a multicenter randomized trial and six non-randomized studies | 218,826 |
Higher mortality in undernourished patients (a randomized trial) Inverse association of BMI and mortality (three studies, follow-up time 5–10 years) Increased BMI associated with high mortality (two Asian studies) Weight loss > 3 kg associated with increased mortality (a population-based study) |
| Xu J et al. 2019 [26] | a nationwide prospective cohort | 1227 | A Chinese study showed that the BMI paradox existed in insulin-resistant patients but does not in insulin-sensitive ischemic stroke patients |
BMI body mass index, WHtR waist-to-height ratio