Department of Surgical and Perioperative Sciences, Sports Medicine, Umeå University, Umeå, Sweden.
Int J Obes (Lond). 2011 Nov;35(11):1427-32. doi: 10.1038/ijo.2011.9. Epub 2011 Feb 22.
Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke.
A cohort of 2751 men and women aged ≥40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age.
During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR)=1.66, 95% confidence interval (CI)=1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR=0.72, 95% CI=0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR=1.49, 95% CI=1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR=1.80, 95% CI=1.06-3.07; HR=1.71, 95% CI=1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension.
Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors.
先前的研究表明，脂肪分布在心血管疾病（CVD）的发展中很重要。我们研究了通过双能 X 射线吸收法（DXA）测量的脂肪分布与中风发病之间的关系。
招募了一个年龄≥40 岁的 2751 名男性和女性队列。使用 DXA 测量腹部、臀型和全身脂肪的基线水平。计算体重指数（BMI，kg/m²）。使用区域中风登记处记录中风发病情况，直至受试者达到 75 岁。
在平均 8 年 9 个月的随访期间，发生了 91 例中风。在所评估的肥胖指数中，腹部脂肪量是女性中风的最佳预测指标（风险比（HR）=1.66，95%置信区间（CI）=1.23-2.24/标准偏差增加），而臀型脂肪与总脂肪量的比例与中风风险降低相关（HR=0.72，95%CI=0.54-0.96）。腹部脂肪量是唯一被评估的肥胖指数，被发现是男性中风的重要预测指标（HR=1.49，95%CI=1.06-2.09）。在调整 BMI 后，腹部脂肪量与中风之间的关联在女性和男性中仍然显著（HR=1.80，95%CI=1.06-3.07；HR=1.71，95%CI=1.13-2.59）。然而，在进一步调整糖尿病、吸烟和高血压后，亚组分析表明腹部脂肪不是一个显著的预测因素。
腹部脂肪量是独立于 BMI 的中风危险因素，但不是独立于糖尿病、吸烟和高血压的危险因素。这表明与腹部脂肪量相关的中风风险增加至少部分是通过传统的中风危险因素介导的。
