The Obesity Paradox: Effect of Body Mass Index and Waist Circumference on Post-Stroke Cognitive Impairment
Bibliographic record
Abstract
Qi Liu,1 Xiaoling Liao,1,2 Yuesong Pan,2 Xianglong Xiang,2 Yumei Zhang2,3 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 3Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Yumei Zhang, Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China, Tel +86-10-59975531, Email zhangyumei95@aliyun.comBackground: Obesity is a risk factor for dementia within the old population however not within the middle-aged population, that is referred to the “obesity paradox”. This study explored the association of body mass index (BMI) and waist circumference (WC) with post-stroke cognitive impairment (PSCI) in middle-aged (40– 65 years) versus old population (≥ 65 years).Methods: The current study enrolled 1735 individuals over the age of 40 who had their first ischemic stroke from the Impairment of Cognition and Sleep (ICONS) subgroup of the China National Stroke Registry-3 (CNSR-3). BMI and WC were used for the diagnosis of obesity and central obesity, respectively. PSCI was diagnosed according to the Montreal Cognitive Assessment (MoCA). The main clinical outcome was the incidence of PSCI assessed at three months after stroke. Multivariable regression analysis was performed to evaluate the association between obesity and three-month PSCI. Stratified analysis was also performed to explore the effect of age on the relationship between obesity and PSCI.Results: In the general population, multivariable logistic regression found that the adjusted odds ratio (OR) with 95% confidence interval (CI) of general obesity was 1.45 (1.06– 1.98) and that of central obesity was 1.54 (1.24– 1.91) for the three-month incidence of PSCI. Stratified analysis by age showed that the adjusted OR with a 95% CI of general obesity was 1.84 (1.24– 2.72) in middle-aged patients and 0.89 (0.52– 1.54) in elderly patients (p-value for interaction = 0.05). Central obesity was associated with PSCI in all age groups: 1.57 (1.18– 2.09) in middle-aged patients and 1.52 (1.08– 2.15) in elderly patients (p-value for interaction= 0.93).Conclusion: General obesity was related to an increased risk of PSCI in middle-aged but not elderly patients, whereas central obesity was associated with an increased risk of PSCI in all age groups, suggesting that the obesity paradox arises only obesity is outlined by BMI.Keywords: post-stroke cognitive impairment, obesity paradox, ischemic stroke, middle-aged and elderly population, follow-up study
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".