Hu Gang, Tuomilehto Jaakko, Silventoinen Karri, Sarti Cinzia, Männistö Satu, Jousilahti Pekka
Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Mannerheimintie 166, FIN-00300 Helsinki, Finland.
Arch Intern Med. 2007 Jul 9;167(13):1420-7. doi: 10.1001/archinte.167.13.1420.
Adiposity is an established risk factor for cardiovascular disease, but the relationship of adiposity with the risk of cerebrovascular disease is still to some extent unclear.
We prospectively investigated the association of different indicators of adiposity (body mass index [BMI] [calculated as weight in kilograms divided by height in meters squared], waist circumference, and waist-hip ratio) with total and type-specific stroke incidence among 49 996 Finnish participants who were aged 25 to 74 years and free of coronary heart disease and stroke at baseline.
During a 19.5-year follow-up, 3228 people developed an incident stroke event (674 hemorrhagic and 2554 ischemic). Compared with normal-weight men (BMI, 18.5-24.9), the multivariate-adjusted (age, study year, smoking, physical activity, educational level, family history of stroke, and alcohol drinking) hazard ratios among lean (BMI, < 18.5), overweight (BMI, 25.0-29.9), and obese (BMI, > or = 30.0) men were 0.74 (95% confidence interval [CI], 0.18-2.96), 1.23 (95% CI, 1.10-1.37), and 1.59 (95% CI, 1.37-1.83) for total stroke, and 0.49 (95% CI, 0.07-3.50), 1.27 (95% CI, 1.12-1.44), and 1.70 (95% CI, 1.45-2.00) for ischemic stroke, respectively. Among women, the corresponding hazard ratios were 1.87 (95% CI, 1.12-3.14), 1.08 (95% CI, 0.95-1.22), and 1.30 (95% CI, 1.14-1.50) for total stroke, and 1.81 (95% CI, 0.97-3.41), 1.11 (95% CI, 0.96-1.28), and 1.41 (95% CI, 1.21-1.64) for ischemic stroke. Abdominal adiposity, defined as the highest quartile of waist circumference or waist-hip ratio, was associated with a greater risk of total and ischemic stroke in men but not in women.
Body mass index was a risk factor for total and ischemic stroke in men and women. Abdominal adiposity was a risk factor for total and ischemic stroke only in men.
肥胖是心血管疾病公认的危险因素，但肥胖与脑血管疾病风险之间的关系在一定程度上仍不明确。
我们前瞻性地研究了肥胖的不同指标（体重指数[BMI][计算方法为体重（千克）除以身高（米）的平方]、腰围和腰臀比）与49996名年龄在25至74岁、基线时无冠心病和中风的芬兰参与者中总体及特定类型中风发病率之间的关联。
在19.5年的随访期间，3228人发生了中风事件（674例出血性中风和2554例缺血性中风）。与正常体重男性（BMI，18.5 - 24.9）相比，在对年龄、研究年份、吸烟、身体活动、教育水平、中风家族史和饮酒进行多变量调整后，瘦（BMI，<18.5）、超重（BMI，25.0 - 29.9）和肥胖（BMI，≥30.0）男性发生总体中风的风险比分别为0.74（95%置信区间[CI]，0.18 - 2.96）、1.23（95%CI，1.10 - 1.37）和1.59（95%CI，1.37 - 1.83），发生缺血性中风的风险比分别为0.49（95%CI，0.07 - 3.50）、1.27（95%CI，1.12 - 1.44）和1.70（95%CI，1.45 - 2.00）。在女性中，总体中风的相应风险比分别为1.87（95%CI，1.12 - 3.14）、1.08（95%CI，0.95 - 1.22）和1.30（95%CI，1.14 - 1.50），缺血性中风的相应风险比分别为1.81（95%CI，0.97 - 3.41）、1.11（95%CI，0.96 - 1.28）和1.41（95%CI，1.21 - 1.64）。腹部肥胖定义为腰围或腰臀比最高四分位数，在男性中与总体和缺血性中风风险增加相关，但在女性中并非如此。
体重指数是男性和女性总体及缺血性中风的危险因素。腹部肥胖仅是男性总体和缺血性中风的危险因素。
