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Associations of obesity measures with subtypes of ischemic stroke in the ARIC Study.

TitleAssociations of obesity measures with subtypes of ischemic stroke in the ARIC Study.
Publication TypeJournal Article
Year of Publication2010
AuthorsYatsuya H, Yamagishi K, North KE, Brancati FL, Stevens J, Folsom AR
Corporate AuthorsARIC Study Investigators
JournalJ Epidemiol
Volume20
Issue5
Pagination347-54
Date Published2010
ISSN1349-9092
KeywordsAfrican Continental Ancestry Group, Body Mass Index, Brain Ischemia, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Obesity, Risk Factors, Stroke, United States, Waist Circumference, Waist-Hip Ratio
Abstract

BACKGROUND: Associations between obesity and lacunar, nonlacunar thrombotic, and cardioembolic stroke are not firmly established.

METHODS: Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR) were recorded at baseline between 1987 and 1989 in the Atherosclerosis Risk in Communities (ARIC) Study for 13 549 black and white adults who were aged from 45 to 64 years and had no history of cardiovascular disease or cancer. The incidence of ischemic stroke subtypes was ascertained from surveillance of hospital records over a median follow-up of 16.9 years. Cox proportional hazards regression analyses adjusted for age, sex, race, education, smoking status and cigarette years, usual ethanol intake, and leisure time sports index were used to estimate hazard ratios (HRs).

RESULTS: The ARIC sample at baseline was 43.8% men and 27.3% blacks; mean age was 53.9 years. Mean BMI, waist circumference, and WHR were 27.7 kg/m(2), 96.8 cm, and 0.92, respectively. The associations of lacunar (n = 138), nonlacunar (n = 338), and cardioembolic (n = 122) ischemic stroke incidence with obesity measures were all generally positive and linear. The HRs for the highest versus lowest quintile of the 3 obesity measures ranged from 1.43-2.21 for lacunar stroke, 1.90-2.16 for nonlacunar stroke, and 2.37-2.91 for cardioembolic stroke.

CONCLUSIONS: Although different pathophysiological mechanisms may exist, the incidences of lacunar, nonlacunar, and cardioembolic stroke were all significantly positively associated with the degree of obesity, regardless of the measure used.

DOI10.2188/jea.je20090186
Alternate JournalJ Epidemiol
PubMed ID20595781
PubMed Central IDPMC2944008
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
P30 ES010126 / ES / NIEHS NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
P30 DK079637 / DK / NIDDK NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States