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Stroke outcome 6.9 X worse if black and overweight (all three related via low vitamin D) – March 2018

Racial differences in intracerebral haemorrhage outcomes in patients with obesity

Obesity Science & Practice Volume 0, Issue 0, published: 30 March 2018, https://doi.org/10.1002/osp4.167
I. Iwuchukwu N. Mahale J. Ryder B. Hsieh B. Jennings D. Nguyen K. Cornwell R. Beyl J. Zabaleta M. Sothern

VitaminDWiki

1) Stroke and low Vitamin D

2) Overview Obesity and Vitamin D contains the following summary

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  • Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study
3) Black and low Vitamin D

Overview Dark Skin and Vitamin D contains the following summary

FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D

 Download the PDF from VitaminDWiki
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Objective: This study was conducted to determine the role of obesity and race in intracerebral haemorrhage (ICH) outcomes.

Methods
The Get with the guideline‐Stroke database was queried for all admitted patients with spontaneous ICH. Secondary causes of ICH were excluded. Body mass index (BMI) was classified using the Center for Disease Control guidelines. Race was classified as White or non‐White. Demographics, clinical, imaging data were retrieved. Outcome measures were hematoma expansion at 24 h and discharge disposition.

Results
A total of 428 patients were included in our analysis. Female gender, past history of congestive heart failure, diabetes mellitus, HbA1c, blood pressure, ICH volume, ICH location, intraventricular haemorrhage and hospital length of stay deferred across BMI categories. On multivariate analysis, along with obese categories, age, ICH location and ICH volume were independent predictors of poor outcomes (hematoma expansion and poor discharge disposition). After adjusting for these variables, obesity remained a predictor of poor disposition outcome compared with normal and overweight subjects; Normal vs. Obese OR 0.26 CI 0.115–0.593 p = 0.0014; Obese vs. Overweight OR 3.79 CI 1.68–8.52 p = 0.0013. Nonetheless, obesity did not influence hematoma expansion. Overall, BMI‐race classification did not influence outcomes. However, among non‐Whites, the obese category had higher odds of a poor disposition outcome than normal (OR 6.84 CI 2.12–22.22 p = 0.0013) or overweight (OR 8.45 CI 2.6–27.49 p = 0.0004) categories.

Conclusion
An obesity paradox in ICH was not observed in our cohort. In the non‐White population, patients with obesity were likely to be associated with poor disposition outcome. Similar findings were not observed in White population.

Created by admin. Last Modification: Thursday May 10, 2018 15:58:59 UTC by admin. (Version 5)

Attached files

ID Name Comment Uploaded Size Downloads
9836 Obese black stroke.jpg admin 10 May, 2018 15:38 38.70 Kb 32
9835 Stroke obese black.pdf PDF 2018 admin 10 May, 2018 15:30 83.02 Kb 29
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