RESEARCH ARTICLE
Maintenance of body weight is an important determinant for the risk of ischemic stroke: A nationwide population-based cohort study Jung-Hwan Cho1‡, Eun-Jung Rhee1‡, Se Eun Park1, Hyemi Kwon1, Jin-Hyung Jung ID2, Kyung-Do Han2, Yong-Gyu Park2, Soon-Jib Yoo3, Yang-Hyun Kim4☯*, WonYoung Lee ID1☯*, Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity¶
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1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea, 2 Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea, 3 Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea, 4 Department of Family Medicine, Korea University Hospital, College of Medicine, Korea University, Seoul, Republic of Korea ☯ These authors contributed equally to this work. ‡ JHC and EJR contributed equally to this work as first authors. ¶ The complete membership of the group can be found in the Acknowledgments. *
[email protected] (WYL);
[email protected] (YHK)
OPEN ACCESS Citation: Cho J-H, Rhee E-J, Park SE, Kwon H, Jung J-H, Han K-D, et al. (2019) Maintenance of body weight is an important determinant for the risk of ischemic stroke: A nationwide populationbased cohort study. PLoS ONE 14(1): e0210153. https://doi.org/10.1371/journal.pone.0210153 Editor: Sabine Rohrmann, University of Zurich, SWITZERLAND Received: February 15, 2018 Accepted: December 18, 2018
Abstract Background Overweight is known as a risk factor for ischemic stroke. However, the effect of weight change on the development of ischemic stroke remains controversial. We investigated the relationship between weight change and the risk of ischemic stroke using a nationwide population-based cohort.
Published: January 3, 2019 Copyright: © 2019 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The data underlying our study are third party data. Data are available from the NHIS Institutional Data Access/Ethics Committee for researchers who meet the criteria for access to confidential data. For information on request data from the NHIS Institutional Data Access/Ethics Committee, please see: https://nhiss. nhis.or.kr/bd/ab/bdaba032eng.do. Funding: This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development
Methods Our study enrolled 11,084,683 participants (Mean age 49.7±13.5 years, range 20–114 years) in the Korean National Health Screening Program from 2009 to 2012. Weight change was calculated using the difference between the baseline weight and the weight at health screening four years prior to the baseline. The occurrence of newly-diagnosed ischemic stroke was observed until the end of 2015. We categorized the study population according to weight change and performed multivariable analysis to compare the risk.
Results Ischemic stroke was newly diagnosed in 113,591 subjects. The crude incidence rates of ischemic stroke per 1000 person-years according to the change in body weight were 3.059, 1.906, and 1.491 in the
