Association Between Different Obesity Measures and the Risk of Stroke in the EPIC Spanish Cohort

Overview

Journal Eur J Nutr

Specialty Nutritional Sciences

Date 2014 Jun 7

PMID 24903807

Citations 19

Authors

Itziar Abete

Larraitz Arriola

Nerea Etxezarreta

Imanol Mozo

Conchi Moreno-Iribas

Pilar Amiano

Nerea Egues

Estibaliz Goyenechea

Adolfo Lopez de Munain

Maite Martinez

Noemi Travier

Carmen Navarro

Maria-Dolores Chirlaque

Maria-Jose Tormo

Diana Gavrila

Jose Maria Huerta

Maria-Jose Sanchez

Esther Molina-Montes

Mar Requena

Maria-Dolores Jimenez-Hernandez

Eva Ardanaz

Aurelio Barricarte

Jose Ramon Quiros

Laudina Rodriguez

Miren Dorronsoro

Affiliations

Soon will be listed here.

Abstract

Introduction: There is still a scientific debate on the exact role played by obesity on stroke risk.

Objective: 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.

Results: 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).

Conclusions: 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.

Citing Articles

A Body Shape Index as a Simple Anthropometric Marker for the Risk of Cardiovascular Events.

Yusoff F, Kajikawa M, Yamaji T, Mizobuchi A, Kishimoto S, Maruhashi T Curr Cardiol Rep. 2025; 27(1):46.

PMID: 39904955 DOI: 10.1007/s11886-025-02192-0.

Joint association of triglyceride glucose index (TyG) and a body shape index (ABSI) with stroke incidence: a nationwide prospective cohort study.

Zhang R, Hong J, Wu Y, Lin L, Chen S, Xiao Y Cardiovasc Diabetol. 2025; 24(1):7.

PMID: 39762919 PMC: 11705842. DOI: 10.1186/s12933-024-02569-5.

Joint and interactive associations of body mass index and genetic factors with cardiovascular disease: a prospective study in UK Biobank.

Huang R, Kong X, Geng R, Wu J, Chen T, Li J BMC Public Health. 2024; 24(1):2371.

PMID: 39223569 PMC: 11367834. DOI: 10.1186/s12889-024-19916-6.

Association of Body Shape Index with Cerebral Small Vessel Disease.

Nam K, Kwon H, Jeong H, Park J, Kwon H Obes Facts. 2022; 16(2):204-211.

PMID: 36535265 PMC: 10028365. DOI: 10.1159/000528701.

Associations between abdominal obesity and the risk of stroke in Chinese older patients with obstructive sleep apnea: Is there an obesity paradox?.

Su X, Li K, Yang L, Yang Y, Gao Y, Gao Y Front Aging Neurosci. 2022; 14:957396.

PMID: 36172486 PMC: 9510899. DOI: 10.3389/fnagi.2022.957396.

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