Abete Itziar, Arriola Larraitz, Etxezarreta Nerea, Mozo Imanol, Moreno-Iribas Conchi, Amiano Pilar, Egüés Nerea, Goyenechea Estibaliz, Lopez de Munain Adolfo, Martinez Maite, Travier Noemi, Navarro Carmen, Chirlaque Maria-Dolores, Tormo Maria-Jose, Gavrila Diana, Huerta Jose Maria, Sánchez María-José, Molina-Montes Esther, Requena Mar, Jiménez-Hernández Maria-Dolores, Ardanaz Eva, Barricarte Aurelio, Quiros Jose Ramon, Rodriguez Laudina, Dorronsoro Miren
Neuroscience Department, Health Research Institute Biodonostia, Po Doctor Begiristain, San Sebastian, 20014, Spain,
Eur J Nutr. 2015 Apr;54(3):365-75. doi: 10.1007/s00394-014-0716-x. Epub 2014 Jun 6.
There is still a scientific debate on the exact role played by obesity on stroke risk.
The aim of the study was to analyze the association between obesity, measured by different indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a new one called A Body Shape Index (ABSI) and the risk of total and ischemic stroke.
SUBJECTS/METHODS: A total of 41,020 subjects (15,490 men and 25,530 women) aged 29-69 years participated in the study. All participants were recruited between 1992 and 1996 and followed up until 2008 to ascertain incident cerebrovascular disease events. Cox proportional hazards models were designed to estimate the relative risk and 95% CI between obesity and cerebrovascular disease incidence.
After 13.8 years of follow-up, a total of 674 stroke cases (55.3% in men) were registered (531 ischemic, 79 hemorrhagic, 42 subarachnoid hemorrhage and 22 unspecified). WC fourth quartile (HR 1.95; 95% CI 1.20-3.19) and WHR fourth quartile (HR 1.58; 95% CI 1.12-2.25) were positively associated with total stroke only in men. BMI was not associated with stroke incidence. The new index, ABSI, was significantly associated with total stroke incidence only in men (HR 1.54; 95% CI 1.06-2.23).
Data from the Spanish EPIC cohort study show a strong association of WC and WHR with the relative risk of suffering a stroke only in men, while no associations were found for BMI. It supports the suggestion of other authors of using more than one obesity index in the study of stroke risk prediction.
关于肥胖在中风风险中的确切作用仍存在科学争论。
本研究旨在分析通过不同指标衡量的肥胖与全中风及缺血性中风风险之间的关联，这些指标包括体重指数（BMI）、腰围（WC）、腰臀比（WHR）以及一种新的指标——体型指数（ABSI）。
研究对象/方法：共有41020名年龄在29至69岁之间的受试者（15490名男性和25530名女性）参与了该研究。所有参与者于1992年至1996年间招募，并随访至2008年以确定脑血管疾病事件的发生情况。设计Cox比例风险模型以估计肥胖与脑血管疾病发病率之间的相对风险及95%置信区间。
经过13.8年的随访，共记录了674例中风病例（男性占55.3%）（531例缺血性中风、79例出血性中风、42例蛛网膜下腔出血和22例未明确类型）。仅在男性中，WC第四四分位数（HR 1.95；95% CI 1.20 - 3.19）和WHR第四四分位数（HR 1.58；95% CI 1.12 - 2.25）与全中风呈正相关。BMI与中风发病率无关。新指标ABSI仅在男性中与全中风发病率显著相关（HR 1.54；95% CI 1.06 - 2.23）。
西班牙EPIC队列研究的数据表明，仅在男性中，WC和WHR与中风相对风险密切相关，而BMI未发现相关性。这支持了其他作者关于在中风风险预测研究中使用多种肥胖指标的建议。
