Background and aims: Studies of the association between obesity and total mortality and recurrent stroke events have shown contradictory results. Therefore, we aimed to conduct a meta-analysis to examine the association of body mass index (BMI) with total mortality and recurrent stroke events among patients after stroke onset.
Methods: We performed an electronic search of PubMed, EMBASE and the Cochrane Library Database, as well as a bibliography review to identify relevant cohort studies published prior to 15th December 2015. Estimates of relative risks (RRs) and corresponding 95% confidence intervals (CIs) comparing underweight, overweight and obese groups with normal weight were pooled using random effects models.
Results: In total, 15 studies with 122,472 stroke patients were eligible for inclusion in the meta-analysis. Compared with the normal weight group, obese stroke patients had a significant decreased risk for total mortality (RR = 0.83, 95% CI, 0.73-0.93, p = 0.002), while underweight patients had a significant increased risk for total mortality (RR = 1.54, 95% CI, 1.31-1.82, p = 3.66 × 10-7). A similar, but not significant, association of BMI categories with recurrent stroke events was also observed. Furthermore, the dose-response meta-analysis identified a nonlinear trend for total mortality and a linear trend for recurrent stroke events, associated with BMI.
Conclusions: Our results suggested that obesity may have a protective effect on total mortality and recurrent stroke events among patients with established stroke.
Keywords: Body mass index; Meta-analysis; Mortality; Recurrent stroke.
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