Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS)
The etiology of an ischemic stroke remains undetermined in 20-35% of cases and many patients do not have any of the conventional risk factors. Increased visceral adipose tissue (VAT) is a suggested new risk factor for both carotid artery atherosclerosis (CAA) and atrial fibrillation (AF), but its ro...
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| creator | Muuronen, Antti T Taina, Mikko Hedman, Marja Marttila, Jarkko Kuusisto, Johanna Onatsu, Juha Vanninen, Ritva Jäkälä, Pekka Sipola, Petri Mustonen, Pirjo |
| description | The etiology of an ischemic stroke remains undetermined in 20-35% of cases and many patients do not have any of the conventional risk factors. Increased visceral adipose tissue (VAT) is a suggested new risk factor for both carotid artery atherosclerosis (CAA) and atrial fibrillation (AF), but its role in the remaining stroke population is unknown. We assessed the amount of VAT in patients with embolic stroke of undetermined source (ESUS) after excluding major-risk cardioembolic sources, occlusive atherosclerosis, and lacunar stroke.
Altogether 58 patients (mean age 57.7 ± 10.2 years, 44 men) with ischemic stroke of unknown etiology but without CAA, known AF or small vessel disease underwent computed tomography angiography and assessment of VAT. For comparison VAT values from three different reference populations were used. Conventional risk factors (smoking, hypertension, diabetes, increased total and LDL-cholesterol, decreased HDL-cholesterol) were also registered.
Mean VAT area was significantly higher in stroke patients (205 ± 103 cm2 for men and 168 ± 99 cm2 for women) compared to all reference populations (P < 0.01). 50% of male and 57% of female patients had an increased VAT area. In male patients, VAT was significantly higher despite similar body mass index (BMI). Increased VAT was more common than any of the conventional risk factors.
Increased VAT was found in over half of our patients with ESUS suggesting it may have a role in the pathogenesis of thromboembolism in this selected group of patients. |
| doi_str_mv | 10.1371/journal.pone.0120598 |
| format | Article |
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Altogether 58 patients (mean age 57.7 ± 10.2 years, 44 men) with ischemic stroke of unknown etiology but without CAA, known AF or small vessel disease underwent computed tomography angiography and assessment of VAT. For comparison VAT values from three different reference populations were used. Conventional risk factors (smoking, hypertension, diabetes, increased total and LDL-cholesterol, decreased HDL-cholesterol) were also registered.
Mean VAT area was significantly higher in stroke patients (205 ± 103 cm2 for men and 168 ± 99 cm2 for women) compared to all reference populations (P < 0.01). 50% of male and 57% of female patients had an increased VAT area. In male patients, VAT was significantly higher despite similar body mass index (BMI). Increased VAT was more common than any of the conventional risk factors.
Increased VAT was found in over half of our patients with ESUS suggesting it may have a role in the pathogenesis of thromboembolism in this selected group of patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0120598</identifier><identifier>PMID: 25756793</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adipose tissue ; Adult ; Aged ; Angiography ; Arteriosclerosis ; Atherosclerosis ; Blood cholesterol ; Body fat ; Body mass ; Body Mass Index ; Body size ; Brain Ischemia - etiology ; Brain Ischemia - pathology ; Cardiac arrhythmia ; Carotid artery ; Case-Control Studies ; Cholesterol ; Clinical medicine ; Computed tomography ; Development and progression ; Diabetes mellitus ; Disease ; Embolism - etiology ; Embolism - pathology ; Embolisms ; Ethnicity ; Etiology ; Female ; Fibrillation ; Gene expression ; Health risks ; High density lipoprotein ; Hispanic people ; Hospitals ; Humans ; Hypertension ; Insulin resistance ; Intra-Abdominal Fat - pathology ; Ischemia ; Low density lipoprotein ; Male ; Medical imaging ; Medicine ; Middle Aged ; Obesity ; Obesity - complications ; Obesity - pathology ; Pathogenesis ; Patients ; Physiological aspects ; Population ; Populations ; Risk analysis ; Risk Factors ; Smoking ; Stroke ; Stroke - etiology ; Stroke - pathology ; Thromboembolism ; Tomography ; Veins & arteries</subject><ispartof>PloS one, 2015-03, Vol.10 (3), p.e0120598-e0120598</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Muuronen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Muuronen et al 2015 Muuronen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-83a172ec35d035bd8c2e8c7ad2bae6794ec24b772325fa8397a15cb453e228253</citedby><cites>FETCH-LOGICAL-c692t-83a172ec35d035bd8c2e8c7ad2bae6794ec24b772325fa8397a15cb453e228253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354901/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354901/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25756793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Kiechl, Stefan</contributor><creatorcontrib>Muuronen, Antti T</creatorcontrib><creatorcontrib>Taina, Mikko</creatorcontrib><creatorcontrib>Hedman, Marja</creatorcontrib><creatorcontrib>Marttila, Jarkko</creatorcontrib><creatorcontrib>Kuusisto, Johanna</creatorcontrib><creatorcontrib>Onatsu, Juha</creatorcontrib><creatorcontrib>Vanninen, Ritva</creatorcontrib><creatorcontrib>Jäkälä, Pekka</creatorcontrib><creatorcontrib>Sipola, Petri</creatorcontrib><creatorcontrib>Mustonen, Pirjo</creatorcontrib><title>Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS)</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The etiology of an ischemic stroke remains undetermined in 20-35% of cases and many patients do not have any of the conventional risk factors. Increased visceral adipose tissue (VAT) is a suggested new risk factor for both carotid artery atherosclerosis (CAA) and atrial fibrillation (AF), but its role in the remaining stroke population is unknown. We assessed the amount of VAT in patients with embolic stroke of undetermined source (ESUS) after excluding major-risk cardioembolic sources, occlusive atherosclerosis, and lacunar stroke.
Altogether 58 patients (mean age 57.7 ± 10.2 years, 44 men) with ischemic stroke of unknown etiology but without CAA, known AF or small vessel disease underwent computed tomography angiography and assessment of VAT. For comparison VAT values from three different reference populations were used. Conventional risk factors (smoking, hypertension, diabetes, increased total and LDL-cholesterol, decreased HDL-cholesterol) were also registered.
Mean VAT area was significantly higher in stroke patients (205 ± 103 cm2 for men and 168 ± 99 cm2 for women) compared to all reference populations (P < 0.01). 50% of male and 57% of female patients had an increased VAT area. In male patients, VAT was significantly higher despite similar body mass index (BMI). Increased VAT was more common than any of the conventional risk factors.
Increased VAT was found in over half of our patients with ESUS suggesting it may have a role in the pathogenesis of thromboembolism in this selected group of patients.</description><subject>Adipose tissue</subject><subject>Adult</subject><subject>Aged</subject><subject>Angiography</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Blood cholesterol</subject><subject>Body fat</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body size</subject><subject>Brain Ischemia - etiology</subject><subject>Brain Ischemia - pathology</subject><subject>Cardiac arrhythmia</subject><subject>Carotid artery</subject><subject>Case-Control Studies</subject><subject>Cholesterol</subject><subject>Clinical medicine</subject><subject>Computed tomography</subject><subject>Development and progression</subject><subject>Diabetes mellitus</subject><subject>Disease</subject><subject>Embolism - etiology</subject><subject>Embolism - pathology</subject><subject>Embolisms</subject><subject>Ethnicity</subject><subject>Etiology</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Gene expression</subject><subject>Health risks</subject><subject>High density lipoprotein</subject><subject>Hispanic people</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Insulin resistance</subject><subject>Intra-Abdominal Fat - pathology</subject><subject>Ischemia</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - pathology</subject><subject>Pathogenesis</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Population</subject><subject>Populations</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Stroke</subject><subject>Stroke - etiology</subject><subject>Stroke - pathology</subject><subject>Thromboembolism</subject><subject>Tomography</subject><subject>Veins & arteries</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk01v1DAQhiMEomXhHyCwhITawy6xHcfOBamqCqxUqRJLuVqOM9n1NomD7ZSPX4-3m1Yb1APKIZHnmXc872SS5DVOF5hy_GFrB9epZtHbDhYpJikrxJPkGBeUzHOS0qcH30fJC--3acqoyPPnyRFhnOW8oMfJn2WnHSgPFbo1XoNTDVKV6a0HFIz3AyDlkUK9DdAFE6PO-BtUKx2sQ6ZDvQomRjz6acIGQVvaxmjkg7M3gGyNhq6CAK41XSzh4501oJOL1fXq9GXyrFaNh1fje5Zcf7r4dv5lfnn1eXl-djnXeUHCXFCFOQFNWZVSVlZCExCaq4qUCmITGWiSlZwTSlitBC24wkyXGaNAiCCMzpK3e92-sV6OtnmJ8xwXgudERGK5JyqrtrJ3plXut7TKyLsD69ZSuWB0AzLVlagAp1hxyAhPRZVjXtSMKsYIJmXU-jhWG8oWKh29iZ5ORKeRzmzk2t7KjLKsSHEUOBkFnP0xgA-y3Q2maVQHdri7N8kpL-L4Zsm7f9DHuxuptYoNmK62sa7eicqzjORM5IJkkVo8QsWngtbo-I_VJp5PEk4nCZEJ8Cus1eC9XK6-_j979X3Kvj9gN6CasPG2GYKxnZ-C2R7UznrvoH4wGadytyL3bsjdishxRWLam8MBPSTd7wT9C49BDA0</recordid><startdate>20150310</startdate><enddate>20150310</enddate><creator>Muuronen, Antti T</creator><creator>Taina, Mikko</creator><creator>Hedman, Marja</creator><creator>Marttila, Jarkko</creator><creator>Kuusisto, Johanna</creator><creator>Onatsu, Juha</creator><creator>Vanninen, Ritva</creator><creator>Jäkälä, Pekka</creator><creator>Sipola, Petri</creator><creator>Mustonen, Pirjo</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150310</creationdate><title>Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS)</title><author>Muuronen, Antti T ; Taina, Mikko ; Hedman, Marja ; Marttila, Jarkko ; Kuusisto, Johanna ; Onatsu, Juha ; Vanninen, Ritva ; Jäkälä, Pekka ; Sipola, Petri ; Mustonen, Pirjo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-83a172ec35d035bd8c2e8c7ad2bae6794ec24b772325fa8397a15cb453e228253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adipose tissue</topic><topic>Adult</topic><topic>Aged</topic><topic>Angiography</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Blood cholesterol</topic><topic>Body fat</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body size</topic><topic>Brain Ischemia - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Muuronen, Antti T</au><au>Taina, Mikko</au><au>Hedman, Marja</au><au>Marttila, Jarkko</au><au>Kuusisto, Johanna</au><au>Onatsu, Juha</au><au>Vanninen, Ritva</au><au>Jäkälä, Pekka</au><au>Sipola, Petri</au><au>Mustonen, Pirjo</au><au>Kiechl, Stefan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS)</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-03-10</date><risdate>2015</risdate><volume>10</volume><issue>3</issue><spage>e0120598</spage><epage>e0120598</epage><pages>e0120598-e0120598</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The etiology of an ischemic stroke remains undetermined in 20-35% of cases and many patients do not have any of the conventional risk factors. Increased visceral adipose tissue (VAT) is a suggested new risk factor for both carotid artery atherosclerosis (CAA) and atrial fibrillation (AF), but its role in the remaining stroke population is unknown. We assessed the amount of VAT in patients with embolic stroke of undetermined source (ESUS) after excluding major-risk cardioembolic sources, occlusive atherosclerosis, and lacunar stroke.
Altogether 58 patients (mean age 57.7 ± 10.2 years, 44 men) with ischemic stroke of unknown etiology but without CAA, known AF or small vessel disease underwent computed tomography angiography and assessment of VAT. For comparison VAT values from three different reference populations were used. Conventional risk factors (smoking, hypertension, diabetes, increased total and LDL-cholesterol, decreased HDL-cholesterol) were also registered.
Mean VAT area was significantly higher in stroke patients (205 ± 103 cm2 for men and 168 ± 99 cm2 for women) compared to all reference populations (P < 0.01). 50% of male and 57% of female patients had an increased VAT area. In male patients, VAT was significantly higher despite similar body mass index (BMI). Increased VAT was more common than any of the conventional risk factors.
Increased VAT was found in over half of our patients with ESUS suggesting it may have a role in the pathogenesis of thromboembolism in this selected group of patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25756793</pmid><doi>10.1371/journal.pone.0120598</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1661987628 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adipose tissue Adult Aged Angiography Arteriosclerosis Atherosclerosis Blood cholesterol Body fat Body mass Body Mass Index Body size Brain Ischemia - etiology Brain Ischemia - pathology Cardiac arrhythmia Carotid artery Case-Control Studies Cholesterol Clinical medicine Computed tomography Development and progression Diabetes mellitus Disease Embolism - etiology Embolism - pathology Embolisms Ethnicity Etiology Female Fibrillation Gene expression Health risks High density lipoprotein Hispanic people Hospitals Humans Hypertension Insulin resistance Intra-Abdominal Fat - pathology Ischemia Low density lipoprotein Male Medical imaging Medicine Middle Aged Obesity Obesity - complications Obesity - pathology Pathogenesis Patients Physiological aspects Population Populations Risk analysis Risk Factors Smoking Stroke Stroke - etiology Stroke - pathology Thromboembolism Tomography Veins & arteries |
| title | Increased visceral adipose tissue as a potential risk factor in patients with embolic stroke of undetermined source (ESUS) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T15%3A49%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Increased%20visceral%20adipose%20tissue%20as%20a%20potential%20risk%20factor%20in%20patients%20with%20embolic%20stroke%20of%20undetermined%20source%20(ESUS)&rft.jtitle=PloS%20one&rft.au=Muuronen,%20Antti%20T&rft.date=2015-03-10&rft.volume=10&rft.issue=3&rft.spage=e0120598&rft.epage=e0120598&rft.pages=e0120598-e0120598&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0120598&rft_dat=%3Cgale_plos_%3EA426586824%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1661987628&rft_id=info:pmid/25756793&rft_galeid=A426586824&rft_doaj_id=oai_doaj_org_article_0cd8de101a7e42708d6179f53a55212b&rfr_iscdi=true |