Obesity and the Risk of Intracerebral Hemorrhage
Author:
Pezzini Alessandro1, Grassi Mario1, Paciaroni Maurizio1, Zini Andrea1, Silvestrelli Giorgio1, Iacoviello Licia1, Di Castelnuovo Augusto1, Del Zotto Elisabetta1, Caso Valeria1, Nichelli Paolo Frigio1, Giossi Alessia1, Volonghi Irene1, Simone Anna Maria1, Lanari Alessia1, Costa Paolo1, Poli Loris1, Pentore Roberta1, Falzone Francesca1, Gamba Massimo1, Morotti Andrea1, Ciccone Alfonso1, Ritelli Marco1, Guido Davide1, Colombi Marina1, De Gaetano Giovanni1, Agnelli Giancarlo1, Padovani Alessandro1
Affiliation:
1. From the Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica (A.P., E.D.Z., A.G., I.V., P.C., L.P., A.M., A.P.), Divisione di Biologia e Genetica, Dipartimento di Scienze Biomediche e Biotecnologie (M.R., M.C.), Università degli Studi di Brescia, Brescia, Italia; Dipartimento di Sanità Pubblica, Sezione di Statistica Medica e Epidemiologia, Università di Pavia, Pavia, Italia (M.G., D.G.); Stroke Unit e Divisione di Medicina Cardiovascolare, Università di Perugia, Perugia, Italia (M...
Abstract
Background and Purpose—
The effect of obesity on the risk of intracerebral hemorrhage (ICH) may depend on the pathophysiology of vessel damage. To further address this issue, we investigated and quantified the correlations between obesity and obesity-related conditions in the causal pathways leading to ICH.
Methods—
A total of 777 ICH cases ≥55 years of age (287 lobar ICH and 490 deep ICH) were consecutively enrolled as part of the Multicenter Study on Cerebral Hemorrhage in Italy and compared with 2083 control subjects by a multivariate path analysis model. Separate analyses were conducted for deep and lobar ICH.
Results—
Obesity was not independently associated with an increased risk of lobar ICH (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.58–1.01) or deep ICH (OR, 1.18; 95% CI, 0.95–1.45) when compared with control subjects. The path analysis confirmed the nonsignificant total effect of obesity on the risk of lobar ICH (OR, 0.77; 95% CI, 0.58–1.02) but demonstrated a significant indirect effect on the risk of deep ICH (OR, 1.28; 95% CI, 1.03–1.57), mostly determined by hypertension (OR, 1.07; 95% CI, 1.04–1.11) and diabetes mellitus (OR, 1.04; 95% CI, 1.01–1.07). Obesity was also associated with an increased risk of deep ICH when compared with lobar ICH (OR, 1.62; 95% CI, 1.14–2.31).
Conclusions—
Obesity increases the risk of deep ICH, mostly through an indirect effect on hypertension and other intermediate obesity-related comorbidities, but has no major influence on the risk of lobar ICH. This supports the hypothesis of different, vessel-specific, biological mechanisms underlying the relationship between obesity and cerebral hemorrhage.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)
Cited by
49 articles.
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