The Impact of Abnormal Distribution of Abdominal Adiposity and Skeletal Muscle on the Prognosis of Ischemic Stroke.

Introduction: This study aimed to investigate the role of novel indicators related to obesity in predicting long-term functional outcomes and the risk of stroke recurrence in participants with first-ever acute ischemic stroke (AIS).

Methods: The area and density of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle (SM) at the third lumbar level, as well as the VAT area (VATA)-to-SM area (SMA) ratio (VSR) and the SAT area-to-SMA ratio (SSR) were assessed using whole-abdominal computerized tomography upon admission. The primary endpoint was the recurrence of stroke. The secondary outcomes were all-cause mortality and cardio-cerebrovascular origin death (CCVD) specifically due to cardiovascular and cerebrovascular diseases. Cox's proportional hazards regression model was used to examine the associations between the novel indicators of obesity and clinical outcomes.

Results: A total of 1,007 participants were enrolled, with an average follow-up time of 1,445 days. The participants in the high VSR group had a higher rate of stroke recurrence {adjusted hazard ratio, 2.06 (95% confidence interval [CI], 1.35-3.14); p = 0.001}. According to the adjusted analysis, high VSR was significantly associated with an increased risk of all-cause mortality (hazard ratio, 2.26 [95% CI, 1.58-3.24]; p < 0.001) and CCVD (hazard ratio, 2.49 [95% CI, 1.65-3.78]; p < 0.001).

Conclusion: A higher VSR was associated with a higher risk of mortality and stroke recurrence in participants with first-ever AIS.