Abbott R D, Behrens G R, Sharp D S, Rodriguez B L, Burchfiel C M, Ross G W, Yano K, Curb J D
Division of Biostatistics, University of Virginia School of Medicine, Charlottesville 22908.
Stroke. 1994 Dec;25(12):2370-6. doi: 10.1161/01.str.25.12.2370.
While evidence suggests that obesity has an independent relation to coronary artery disease, similar findings for stroke have not been established. The purpose of this study was to examine the relation between body mass index and the risk of thromboembolic stroke independently of other risk factors.
Since 1965, the Honolulu Heart Program has followed a cohort of men in a prospective study of cardiovascular disease. This article examines the relationship between the baseline measurement of body mass index and the risk of thromboembolic stroke in 1163 nonsmoking men in older middle age (55 to 68 years). Men who had an elevated risk of stroke due to hypertension, diabetes, and other risk factors were excluded from the analysis.
After 22 years of follow-up, the rate of stroke increased significantly with increasing levels of body mass (P < .01). In the bottom tertile of the body mass index, the rate of thromboembolic stroke was 28.7 per 1000 (11/383). In the middle tertile, the rate was increased by 40% to 40.7 per 1000 (16/393), and in the top tertile, the rate of thromboembolic stroke was 55.4 per 1000 (21/387), a twofold excess compared with the bottom tertile. After adjustment for age and the residual effects of confounding risk factors, including systolic blood pressure and serum glucose, the estimated relative risk of stroke for the average body mass index in the top tertile (26.6 kg/m2) compared with that in the bottom tertile (20.3 kg/m2) was 2.1 (95% confidence interval, 1.1 to 4.1). These findings were not affected by coronary events that occurred in the course of follow-up, nor did they appear to be influenced by deaths from other causes.
We conclude that elevated body mass is associated with an increased risk of thromboembolic stroke in nonsmoking men in older middle age who are free of commonly observed conditions related to cardiovascular disease.
虽然有证据表明肥胖与冠状动脉疾病存在独立关联，但肥胖与中风之间的类似关系尚未得到证实。本研究的目的是独立于其他风险因素，研究体重指数与血栓栓塞性中风风险之间的关系。
自1965年以来，檀香山心脏项目对一组男性进行了心血管疾病的前瞻性研究。本文研究了1163名老年中年（55至68岁）非吸烟男性的体重指数基线测量值与血栓栓塞性中风风险之间的关系。因高血压、糖尿病和其他风险因素而中风风险升高的男性被排除在分析之外。
经过22年的随访，中风发生率随着体重水平的升高而显著增加（P <.01）。在体重指数最低的三分位数中，血栓栓塞性中风的发生率为每1000人中有28.7例（11/383）。在中间三分位数中，发生率增加了40%，达到每1000人中有40.7例（16/393），而在最高三分位数中，血栓栓塞性中风的发生率为每1000人中有55.4例（21/387），是最低三分位数的两倍。在调整年龄以及包括收缩压和血糖在内的混杂风险因素的残余影响后，最高三分位数（26.6 kg/m2）的平均体重指数与最低三分位数（20.3 kg/m2）相比，中风的估计相对风险为2.1（95%置信区间，1.1至4.1）。这些发现不受随访期间发生的冠状动脉事件的影响，也似乎不受其他原因导致的死亡的影响。
我们得出结论，在没有常见心血管疾病相关状况的老年中年非吸烟男性中，体重升高与血栓栓塞性中风风险增加有关。
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