A clinical follow-up study on the risk of cerebral infarction in Chinese aging overweight and obese population

The current studies have shown that overweight and obesity are possible risk factors for cerebral infarction, but variety of weight status in the role of the mechanism of cerebral infarction is not yet fully understood. In our research, a prospective cohort follow-up study of 8 years (2002-2009) was used to analyze the correlation of weight, cerebral infarction and other factors in 1170 Han retired employees from KaiLuan Group. The study included enrolling with questionnaire survey, medical examination, brain CT scan and so on, based on the changes in body mass index from the beginning to the end of the follow-up study, the subjects were divided into eight groups: stay normal weight group (n = 364), stay overweight group (n = 171), development from overweight into obesity group (n = 95), stay obesity group (n = 37), development from normal weight into overweight group (n = 365), development from normal weight into obesity group (n = 63), overweight improved group (n = 55) and obesity improved group (n = 20). We found that the incidence of cerebral infarction in the stay overweight group was higher than in the stay obese and stay normal weight groups (25.15%, 18.92%, 19.23%, P < 0.05) during the last medical examination in the end of follow-up study, and relative risk was 1.31, 0.98, 1, and population attributable risk was 0.10, -0.002, 0, respectively. But there was no difference of the incidence of cerebral infarction between stay obesity group and stay normal weight group (P > 0.05). The incidence of hypertension in the development of normal weight into obesity group and stay obesity group was higher than stay overweight group and stay normal weight group (63.49%, 56.76%, 48.54%, 36.54%, P < 0.05), while the aggregated incidence of risk factors in above mentioned four groups was 75%, 64%, 63%, 55% (P < 0.05), respectively. In logistic regression analysis of correlative factors to cerebral infarction, waist circumference in the last checkup, diabetes, development from normal weight to overweight status, etc were selected (P < 0.01), and odds ratio (OR) values were 0.98, 6.51, 4.13 (P < 0.05), respectively. The incidence of cerebral infarction in overweight improved and obesity improved groups were 29.09%, 45.00%, relative risk values were 1.51, 2.34, the aggregated incidence of risk factors were 48%, 65%. This study showed that Chinese aging population who has overweight with a significant overweight stable phase and with no overweight stable phase but progressing to obesity had different risks of diseases. The former was at high risk of cerebral infarction, the latter was susceptible to hypertension. In the aging population of overweight and obesity, the aggregated incidence of cerebral infarction related risk factors were significantly increased, and weight-loss treatment did not reduce the incidence of cerebral infarction. Thus, the aging patients with obesity should be actively treated to eliminate hypertension and other risk factors, rather than an appetite for weight-loss treatment. Crown Copyright (C) 2010 Published by Elsevier Ltd on behalf of Asian Oceanian Association for the Study of Obesity. All rights reserved.