Aune D, Sen A, Norat T, Janszky I, Romundstad P, Tonstad S, et al. Body Mass Index, Abdominal Fatness, and Heart Failure Incidence and Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Circulation. 2016;133:639–49.

Article  PubMed  Google Scholar 

Collaboration NCDRF. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016;387:1377–96.

Article  Google Scholar 

Mongraw-Chaffin M, Foster MC, Kalyani RR, Vaidya D, Burke GL, Woodward M, et al. Obesity Severity and Duration Are Associated With Incident Metabolic Syndrome: Evidence Against Metabolically Healthy Obesity From the Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab. 2016;101:4117–24.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010;56:1113–32.

Article  PubMed  Google Scholar 

Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006;113:898–918.

Article  PubMed  Google Scholar 

Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377:557–67.

Article  PubMed  PubMed Central  Google Scholar 

Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365:1415–28.

Article  CAS  PubMed  Google Scholar 

Ma YH, Leng XY, Dong Y, Xu W, Cao XP, Ji X, et al. Risk factors for intracranial atherosclerosis: A systematic review and meta-analysis. Atherosclerosis. 2019;281:71–7.

Article  CAS  PubMed  Google Scholar 

Liu L, Shi Z, Ji X, Zhang W, Luan J, Zahr T, et al. Adipokines, adiposity, and atherosclerosis. Cell Mol Life Sci. 2022;79:272.

Article  CAS  PubMed  Google Scholar 

White H, Boden-Albala B, Wang C, Elkind MS, Rundek T, Wright CB, et al. Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study. Circulation. 2005;111:1327–31.

Article  PubMed  Google Scholar 

Wong LK. Global burden of intracranial atherosclerosis. Int J Stroke. 2006;1:158–9.

Article  PubMed  Google Scholar 

Wang Y, Zhao X, Liu L, Soo YO, Pu Y, Pan Y, et al. Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese Intracranial Atherosclerosis (CICAS) Study. Stroke. 2014;45:663–9.

Article  PubMed  Google Scholar 

Wang A, Wu J, Zhou Y, Guo X, Luo Y, Wu S, et al. Measures of adiposity and risk of stroke in China: a result from the Kailuan study. PLoS One. 2013;8:e61665.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Zhou Y, Li Y, Xu L, Xu J, Wang A, Gao X, et al. Asymptomatic polyvascular abnormalities in community (APAC) study in China: objectives, design and baseline characteristics. PLoS One. 2013;8:e84685.

Article  PubMed  PubMed Central  Google Scholar 

Fan C, Zhang Q, Zhang S, Wang A, Bi X, Chen S, et al. Association of Newly Found Asymptomatic Intracranial Artery Stenosis and Ideal Cardiovascular Health Metrics in Chinese Community Population. Sci Rep. 2020;10:7200.

Article  CAS  PubMed  PubMed Central  Google Scholar 

WHO Consultation on Obesity (1999: Geneva, Switzerland) & WorldHealth Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. World Health Organization; 2000. https://iris.who.int/handle/10665/42330.

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.

Article  CAS  PubMed  Google Scholar 

Chen C, Lu FC. The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci. 2004;17:1–36.

PubMed  Google Scholar 

Hinnouho GM, Czernichow S, Dugravot A, Batty GD, Kivimaki M, Singh-Manoux A. Metabolically healthy obesity and risk of mortality: does the definition of metabolic health matter? Diabetes Care. 2013;36:2294–300.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Carmelli D, Swan GE, Bliwise DL. Relationship of 30-year changes in obesity to sleep-disordered breathing in the Western Collaborative Group Study. Obes Res. 2000;8:632–7.

Article  CAS  PubMed  Google Scholar 

Kramer H, Gutierrez OM, Judd SE, Muntner P, Warnock DG, Tanner RM, et al. Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study. Am J Kidney Dis. 2016;67:62–9.

Article  PubMed  Google Scholar 

Fan J, Song Y, Chen Y, Hui R, Zhang W. Combined effect of obesity and cardio-metabolic abnormality on the risk of cardiovascular disease: a meta-analysis of prospective cohort studies. Int J Cardiol. 2013;168:4761–8.

Article  PubMed  Google Scholar 

Putra ICS, Kamarullah W, Prameswari HS, Pramudyo M, Iqbal M, Achmad C, et al. Metabolically unhealthy phenotype in normal weight population and risk of mortality and major adverse cardiac events: A meta-analysis of 41 prospective cohort studies. Diabetes Metab Syndr. 2022;16:102635.

Article  CAS  PubMed  Google Scholar 

Forlivesi S, Cappellari M, Bonetti B. Obesity paradox and stroke: a narrative review. Eat Weight Disord. 2021;26:417–23.

Article  PubMed  Google Scholar 

Zhao L, Du W, Zhao X, Liu L, Wang C, Wang Y, et al. Favorable functional recovery in overweight ischemic stroke survivors: findings from the China National Stroke Registry. J Stroke Cerebrovasc Dis. 2014;23:e201–6.

Article  PubMed  Google Scholar 

Andersen KK, Olsen TS. The obesity paradox in stroke: lower mortality and lower risk of readmission for recurrent stroke in obese stroke patients. Int J Stroke. 2015;10:99–104.

Article  PubMed  Google Scholar 

Xu J, Wang A, Meng X, Jing J, Wang Y, Wang Y, et al. Obesity-Stroke Paradox Exists in Insulin-Resistant Patients But Not Insulin Sensitive Patients. Stroke. 2019;50:1423–9.

Article  CAS  PubMed  Google Scholar 

Vemmos K, Ntaios G, Spengos K, Savvari P, Vemmou A, Pappa T, et al. Association between obesity and mortality after acute first-ever stroke: the obesity-stroke paradox. Stroke. 2011;42:30–6.

Article  PubMed  Google Scholar 

Wang Y, Li J, Johnston SC, Hankey GJ, Easton JD, Meng X, et al. Colchicine in High-risk Patients with Acute Minor-to-moderate Ischemic Stroke or Transient Ischemic Attack (CHANCE-3): Rationale and design of a multicenter randomized placebo-controlled trial. Int J Stroke. 2023;18:873–8.

Article  PubMed  Google Scholar 

Rodriguez-Castro E, Rodriguez-Yanez M, Arias-Rivas S, Santamaria-Cadavid M, Lopez-Dequidt I, Hervella P, et al. Obesity Paradox in Ischemic Stroke: Clinical and Molecular Insights. Transl Stroke Res. 2019;10:639–49.

Article  CAS  PubMed  Google Scholar 

Quinones-Ossa GA, Lobo C, Garcia-Ballestas E, Florez WA, Moscote-Salazar LR, Agrawal A. Obesity and Stroke: Does the Paradox Apply for Stroke? Neurointervention. 2021;16:9–19.

Article  PubMed  PubMed Central  Google Scholar 

Shu MJ, Zhai FF, Zhang DD, Han F, Zhou L, Ni J, et al. Metabolic syndrome, intracranial arterial stenosis and cerebral small vessel disease in community-dwelling populations. Stroke Vasc Neurol. 2021;6:589–94.

Article  PubMed  PubMed Central  Google Scholar 

Choi KM, Cho HJ, Choi HY, Yang SJ, Yoo HJ, Seo JA, et al. Higher mortality in metabolically obese normal-weight people than in metabolically healthy obese subjects in elderly Koreans. Clin Endocrinol. 2013;79:364–70.

Article  Google Scholar 

Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444:881–7.

Article  CAS  PubMed  Google Scholar 

Stefan N, Fritsche A, Schick F, Häring H-U. Phenotypes of prediabetes and stratification of cardiometabolic risk. The Lancet. Diabetes Endocrinol. 2016;4:789–98.

Google Scholar 

Stefan N, Kantartzis K, Machann J, Schick F, Thamer C, Rittig K, et al. Identification and Characterization of Metabolically Benign Obesity in Humans. Arch Intern Med. 2008;168:1609–16.

Article  PubMed  Google Scholar 

Fabbrini E, Magkos F, Mohammed BS, Pietka T, Abumrad NA, Patterson BW, et al. Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity. Proc Natl Acad Sci USA. 2009;106:15430–5.

Article  CAS  PubMed  PubMed Central  Google Scholar