Abstract
BackgroundAssociations between obesity and lacunar, nonlacunar thrombotic, and cardioembolic stroke are not firmly established.MethodsBody 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).ResultsThe 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/m2, 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.ConclusionsAlthough 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.
Highlights
Ischemic stroke consists of 3 major subtypes with different etiologies: lacunar, nonlacunar thrombotic, and cardioembolic
Serum cholesterol level, atherosclerosis score, and the extent of artery stenosis were different in infarctions in penetrating artery regions and those in cortical artery regions.[1]
We described incidence rates and hazard ratios of ischemic stroke subtypes in relation to Body mass index (BMI), waist circumference, and waist-to-hip ratio (WHR)
Summary
Ischemic stroke consists of 3 major subtypes with different etiologies: lacunar, nonlacunar thrombotic, and cardioembolic. A previous investigation in the ARIC Study found that body mass index and waist-to-hip ratio were positively associated with nonlacunar and cardioembolic ischemic stroke, but not with lacunar stroke, in a minimally adjusted model.[6] some reports suggest a positive association between the degree of obesity and lacunar stroke incidence in women[7] and with the prevalence of silent lacunar infarct identified by MRI.[8] further studies on this topic. 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. Conclusions: 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
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