An Analysis Of The Effects Of Obesity,triglyceride And Their Interaction On Stroke In Rural Residents Of Liaoning Province

Objective: Stroke is a major public health problem that endangers human health and brings heavy economic burden to individuals,families and society.At present,the effects of obesity and triglyceride(TG)on stroke have not been clarified,and the risk factors leading to stroke need to be further explored.Although certain measures against traditional risk factors have achieved some results in the prevention and treatment of stroke,they cannot fully explain the occurrence of stroke.Hypertriglyceridemic-waist phenotype(HTWP),a combined index of anthropometric obesity and blood lipids,may have a better correlation with stroke.This study took rural residents in Liaoning Province as the research object to explore the incidence of stroke and its adjustable risk factors in rural residents in Liaoning province,northeast China,and to explore the correlation between obesity,TG and stroke.The HTWP was used to screen the high-risk population of stroke in order to provide some reference for the prevention and treatment of stroke.Methods: A cross-sectional study was conducted between 2012 and 2013 using multi-stage stratified random cluster sampling.Three counties(Dawa,Liaoyang and Zhangwu)were randomly selected from the eastern,southern and northern regions of Liaoning Province,then one town was randomly selected from each county,and finally8-10 villages were randomly selected from each town.Finally,26 villages were included.A total of 11956 residents were included in this study,of which 112 residents lacked anthropometric measurements and 90 residents lacked laboratory tests.Finally,11754 residents were screened out,including 1080 stroke patients.SPSS 22.0 software was used for statistical analysis of the collected data,and P≤0.05 was considered statistically significant.In this study,waist to height ratio(WHt R),waistcircumference(WC),body mass index(BMI)and waist to hip ratio(WHR)were adopted.Logistic regression was used to analyze the association between the four obesity indicators and the risk of stroke,as well as the association between TG level and the risk of stroke.Based on the measurement results of serum TG and WC,participants were divided into four phenotype groups:(1)NWNT: normal WC and TC group(2)NWET: only elevated TG group(3)EWNT: only abdominal obesity group(4)HTWP: hypertriglyceridemia blood-waist phenotype group.Regression analysis and stratified analysis were used to explore whether there was interaction between obesity and HTG,and to explore the association between HTWP and stroke.Results:1.A total of 11,754 subjects were included in this study,including 10,674 patients in the non-stroke group and 1080 patients in the stroke group,with a prevalence rate of 9.2%.High triglyceride-waist circumference phenotype was detected in 2234 cases,accounting for 19.0%;the simple triglyceride increased in 1369 cases,accounting for 11.7%;there were 2793 cases of simple abdominal obesity,accounting for 23.8%;normal 5358 cases,accounting for 45.6%.2.Logistic regression analysis was used to analyze the risk of stroke in each obesity measurement index.Univariate analysis showed that the risk of stroke in BMI,WC and WHt R was 1.588 times(95%CI: 1.346-1.873)and 2.025 times(95%CI: 1.729-2.373)2.303 times(95%CI: 1.991-2.663)than that in the normal group,respectively,and the differences were statistically significant.Multivariate analysis showed that obesity defined by BMI was 1.231 times(95%CI: 1.023-1.481)more likely to have stroke than the non-stroke group,while WC,WHR and WHt R were 1.426 times(95%CI:1.197-1.698),1.178 times(95%CI: 1.004-1.381)and 1.412 times(95%CI: 1.201-1.660)more likely to have stroke than the non-stroke group,respectively.The results of the adjusted model showed statistically significant differences.3.Univariate analysis of the risk of stroke with TG showed that the risk of stroke with high TG was 1.738 times(95%CI: 1.530-1.975)that of the non-stroke group.Multivariate analysis showed that the risk of stroke with high TG was 1.326 times(95%CI: 1.121-1.569)that of the non-stroke group,with statistical difference.4.Univariate analysis showed that the risk of stroke in the HTWP group was 2.265 times(95%CI: 1.936-2.651)higher than that in the non-stroke group.Multivariate analysis showed that the risk of stroke in the HTWP group was 1.594 times(95%CI: 1.294-1.964)higher than that in the non-stroke group,while there was no significant difference in NWET and EWNT.5.Stratified analysis of HTWP group and normal group by different stratified variables(age,sex,diabetes,and hypertension)found that the risk of stroke in women with an OR of 1.770(95%CI: 1.323-2.370)was higher than that in men with an OR of 1.474(95%CI:1.072-2.026),OR of 1.665(95%CI: 1.330-2.084),in subjects without diabetes was higher than 1.169(95%CI: 0.603-2.263)in subjects with diabetes,there was no statistical difference in the risk of stroke between the two groups when stratified by age.6.WC and triglyceride were put into the regression model to obtain the OR value and P value of the two variables.After adjusting the relevant model,TG * WC was 1.171(95%CI: 1.093-1.253),and the difference was statistically significant,suggesting that there was a certain multiplication interaction between them.Conclusion:1.There is a certain correlation between obesity defined by BMI,WC,WHR and WHt R and stroke in rural residents of Liaoning province.Obesity may be an important risk factor for stroke.2.TG may be an important risk factor for stroke in rural residents of Liaoning Province.3.Obesity and TG may interact with the incidence of stroke in rural residents in Liaoning province.