Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Aging

Publication type: Original Contributions

IF(IF): 5.515

PMID: 32544081 Link To Pubmed Full text Download

Obesity is a well-established risk factor for vascular disease, with increasing prevalence and significant impact on public health worldwide. It has been reported as an independent predictor for ischemic stroke with an 4% risk increase for each unit augmentation in body mass index. There are several explanations for the mechanism of stroke morbidity caused by obesity. One of them is that inflammatory factors secreted by adipose tissue could bring obese patients suffering from a state of mild chronic inflammation, which can induce elevated LDL-c and CRP level, and the consequent atherogenesis and cardiovascular events. However, few long-term studies have evaluated the consequences of a greater cumulative exposure to a higher degree of adiposity and longer duration of obesity during the obesity epidemic. In this study, we attempt to determine the total cumulative exposure to excess overall adiposity, expressed as excess BMI-years on the incidence of vascular event and the mediation effect of LDL-c and CRP in the Kailuan study. There were several highlights in our study: 1. The Kailuan study was used for a follow-up of up to 12 years, with a total of 6 follow-up points. 2. BMI loading was used to explore the relationship between obesity and stroke. This approach makes full use of information at each follow-up point to better assess the relationship between BMI and stroke. 3. The mediation analysis will be used to explore the mechanism of obesity leading to stroke, and to determine whether CRP and LDL have mediation effects.

The Kailuan study is a prospective, population-based study began in 2006. These total 36,421 participants completed 4 measurements of hs-CRP and LDL-c biennially from 2006-2013. Cumhs-CRP or cumLDLc levels were calculated as the number of interval years multiplied by the Δhs-CRP (more than 2.0 mg/L) or ΔLDL-c (more than 2.6 mmol/L). Outcomes measured during follow-up (2012-2017) were defined as major adverse cardiac events (MACE), including ischemic stroke, myocardial infarction, and all-cause mortality.