Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
PLoS One. 2013 Apr 17;8(4):e61665. doi: 10.1371/journal.pone.0061665. Print 2013.
The objective of this study was to explore the association between adiposity and risk of incident stroke among men and women.
We studied the relationship between adiposity and stroke among 94,744 participants (18-98 years old) in the Kailuan study. During a follow-up of 4 years, 1,547 ischemic or hemorrhagic strokes were recorded. Measurements of adiposity included body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated from Cox regression models and each model fit was assessed using -2log-likelihood.
Every measurement of adiposity was associated with the risk for total stroke and ischemic stroke, but not for hemorrhagic stroke. After adjusting for confounders and intermediates, the HR (comparing the mean of the highest quintile with that of the lowest quintile) for total stroke was 1.34(1.13-1.60) for BMI, 1.26(1.06-1.52) for WC, 1.29(1.08-1.56) for WHpR, and 1.38(1.15-1.66) for WHtR. The HR for ischemic stroke was 1.52(1.24-1.88) for BMI, 1.46(1.17-1.81) for WC, 1.40(1.12-1.74) for WHpR, and 1.62(1.29-2.04) for WHtR. The model fit for each of the indices was similar.
Adiposity increases the total risk of stroke and ischemic stroke, but not of hemorrhagic stroke. No clinically meaningful differences among the associations between BMI, WC, WHpR, and WHtR and stroke incidence were identified in this study.
本研究旨在探讨肥胖与男性和女性卒中发病风险的关系。
我们研究了 94744 名参与者（年龄 18-98 岁）的肥胖与卒中之间的关系。在 4 年的随访期间，记录了 1547 例缺血性或出血性卒中。肥胖的测量指标包括体重指数（BMI）、腰围（WC）、腰臀比（WHpR）和腰围身高比（WHtR）。使用 Cox 回归模型计算危险比（HR）和 95%置信区间（CI），并通过 -2log 似然比评估每个模型的拟合度。
每种肥胖测量指标均与总卒中及缺血性卒中风险相关，但与出血性卒中风险无关。在调整混杂因素和中介因素后，总卒中的 HR（比较最高五分位数与最低五分位数）分别为 BMI 为 1.34（1.13-1.60）、WC 为 1.26（1.06-1.52）、WHpR 为 1.29（1.08-1.56）、WHtR 为 1.38（1.15-1.66）。缺血性卒中的 HR 分别为 BMI 为 1.52（1.24-1.88）、WC 为 1.46（1.17-1.81）、WHpR 为 1.40（1.12-1.74）、WHtR 为 1.62（1.29-2.04）。每个指数的模型拟合度相似。
肥胖增加卒中总发病风险和缺血性卒中风险，但不增加出血性卒中风险。本研究未发现 BMI、WC、WHpR 和 WHtR 与卒中发病率之间的关联存在显著差异。
