Nav: Home

1st-of-its-kind study associates obesity with poorer stroke outcomes in non-white patients

April 26, 2018

New Orleans, LA - Research led by LSU Health New Orleans faculty has found that obesity contributed to poorer outcomes in non-white patients who had hemorrhagic strokes. It is one of the few studies examining outcomes of patients with obesity following intracerebral haemorrhage (ICH) and is the first such study conducted within the stroke belt of the US with a racially diverse population. The findings were published this month in Obesity Science & Practice Early View, available online at https://onlinelibrary.wiley.com/doi/full/10.1002/osp4.167.

"We reported on the racial differences in outcome of patients with obesity following hemorrhagic stroke (intracerebral hemorrhage)," says lead author Dr. Ifeanyi O. Iwuchukwu, LSU Health New Orleans Assistant Professor of Neuroscience. "We defined good outcome based on the likelihood of discharge home or a rehabilitation center."

The retrospective study examined data on 428 patients from the Get with the Guideline-Stroke database. Data included demographics; medical history; clinical, laboratory, and imaging characteristics; BMI and obesity classification; as well as discharge disposition. Fifty percent of the patients were female, 49.1% were non-white (43.7% African-American, 0.9% Asian, 1.9% non-white Hispanic and 2.6% others), and the white population consisted of non-Hispanic whites.

The initial results show that several of the variables were different between the BMI categories - gender, histories of congestive heart failure and diabetes, as well as blood pressure measurements and HbA1c. Good outcome discharge disposition differed significantly across BMI categories. Overall comparison of the white and non-white populations showed age, admission systolic blood pressure, anticoagulant use and ICH location were significantly different between the groups. The difference on outcomes where comparisons were performed within each race group was unexpected.

"In the study group, non-white patients with obesity fared worse than non-white patients without obesity," notes Dr. Iwuchukwu. "A similar finding was not observed in white patients with obesity."

Obesity is an established risk factor for cardiovascular disease including acute cerebrovascular disease - acute ischemic and hemorrhagic strokes. Conversely, several previous reports indicated obesity is associated with better outcomes following several acute conditions - heart failure, carotid endarterectomy, sepsis, bypass surgery and vascular surgery. This phenomenon is known as the "obesity paradox."

"Our findings are important as a previous study on outcomes of 'patients with obesity' following hemorrhagic stroke (intracerebral hemorrhage) suggested that obesity was associated with improved outcomes," Iwuchukwu added. "Importantly, our study differs as our study population included a large African-American population compared to the prior study, which was primarily an Asian population in South Korea. Our study is significant because epidemiologically, ICH is a common type of stroke amongst 30-50 year old African-Americans, and obesity was an independent predictor of outcomes in our study cohort."

Stroke is the fifth leading cause of death in the United States and is a leading cause of chronic disability. According to the Centers for Disease Control and Prevention (CDC), African-Americans are at greater risk of having a stroke. Compared to whites, they are twice as likely to have a stroke, have strokes at younger ages, and are more likely to have more severe strokes or die from them.

"This is the first study to report poor health outcomes following stroke in predominantly African-American versus Caucasian patients with obesity," concludes senior author Dr. Melinda Sothern, Professor and Jim Finks Endowed Chair in Health Promotion at LSU Health New Orleans School of Public Health. "Patients without obesity were less likely to need rehabilitation and more likely to return home following a stroke event. Findings highlight the need to address the nutritional needs of minority populations at high risk for cardiovascular disease in order to reduce the burden of obesity on recovery following stroke."
-end-
The LSU research team also included Dr. Jovanny Zabelata, Associate Research Professor at LSU Health New Orleans' School of Medicine and Stanley S. Scott Cancer Center; and Dr. Robbie Beyl, Assistant Research Professor at LSU's Pennington Biomedical Research Center; and Kristin Cornwell at LSU Health New Orleans School of Public Health; as well as N. Mahale, J. Ryder, B. Hsieh and B. Jennings from Ochsner Medical Center.

The study was supported in part by the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center.

LSU Health Sciences Center New Orleans educates Louisiana's health care professionals. The state's flagship health sciences university, LSU Health New Orleans includes a School of Medicine, the state's only School of Dentistry, Louisiana's only public School of Public Health, and Schools of Allied Health Professions, Nursing, and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena, the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent, advance treatment, or cure disease. To learn more, visit http://www.lsuhsc.edu, http://www.twitter.com/LSUHSCHealth or http://www.facebook.com/LSUHSC.

Louisiana State University Health Sciences Center

Related Obesity Articles:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.
Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.
New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.
Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.
Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).
How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.
Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?
Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.
Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.
Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.
More Obesity News and Obesity Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.