Shimizu Yuji, Imano Hironori, Ohira Tetsuya, Kitamura Akihiko, Kiyama Masahiko, Okada Takeo, Ishikawa Yoshinori, Shimamoto Takashi, Yamagishi Kazumasa, Tanigawa Takeshi, Iso Hiroyasu
Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan; Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, Osaka, Japan.
J Stroke Cerebrovasc Dis. 2014 Apr;23(4):667-74. doi: 10.1016/j.jstrokecerebrovasdis.2013.06.009. Epub 2013 Jul 17.
Several studies have reported that height and risk of stroke are inversely associated based on the hypothesis that height is a marker of childhood physical condition. However, a limited number of studies have taken account of the effect of current physical condition on the relationship between height and risk of stroke.
We conducted a prospective cohort study of 12,222 40- to 69-year-old Japanese patients under systematic surveillance for stroke incidence. Because body mass index (BMI) is regarded as a surrogate marker of current physical condition for cardiovascular risk, we performed a stratified analysis of this risk based on BMI.
During the median 17-year follow-up, there were 565 incident strokes (326 ischemic and 186 hemorrhagic strokes) showing an inverse association between height and risk of stroke independent of classical cardiovascular risk factors. Compared with the lowest height group (<159 cm for men and <148 cm for women) as reference, the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the highest height group (>166 cm for men and >154 cm for women) were 0.70 (95% CI 0.49-1.00; P = .043) for men and 0.44 (95% CI 0.27-0.70; P < .001) for women. When the analysis was restricted to those with BMI <23 kg/m(2), the associations were stronger for both hemorrhagic and ischemic stroke.
Height was found to be inversely associated with risk of stroke for middle-aged Japanese men and women, especially with lower BMIs. Our findings suggest that childhood social and physical conditions may contribute to the development of stroke in adulthood because height is a surrogate marker of these conditions.
多项研究报告称，基于身高是儿童时期身体状况指标这一假设，身高与中风风险呈负相关。然而，仅有少数研究考虑了当前身体状况对身高与中风风险关系的影响。
我们对12222名40至69岁接受中风发病率系统监测的日本患者进行了一项前瞻性队列研究。由于体重指数（BMI）被视为当前心血管疾病风险身体状况的替代指标，我们基于BMI对该风险进行了分层分析。
在中位17年的随访期间，发生了565例中风事件（326例缺血性中风和186例出血性中风），显示身高与中风风险之间存在独立于经典心血管危险因素的负相关。与最低身高组（男性<159厘米，女性<148厘米）作为参照相比，最高身高组（男性>166厘米，女性>154厘米）的多变量风险比（HRs）和95%置信区间（95% CIs），男性为0.70（95% CI 0.49 - 1.00；P = 0.043），女性为0.44（95% CI 0.27 - 0.70；P < 0.001）。当分析仅限于BMI<23 kg/m²的人群时，出血性和缺血性中风的关联更强。
发现身高与中年日本男性和女性的中风风险呈负相关，尤其是BMI较低者。我们的研究结果表明，儿童时期的社会和身体状况可能促成成年期中风的发生，因为身高是这些状况的替代指标。
