Body mass index and stroke incidence in Japanese community residents: The Jichi Medical School (JMS) Cohort Study.

Nami Kawate,Shizukiyo Ishikawa,Kazuhiko Kotani,Kazunori Kayaba,Motohiko Hara

doi:10.1016/j.je.2016.08.007

Nami Kawate, Shizukiyo Ishikawa + Show 3 more

Open Access

https://doi.org/10.1016/j.je.2016.08.007

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Abstract

BackgroundHigh body mass index (BMI) has been reported as a risk factor for cardiovascular events in Western countries, while low BMI has been reported as a risk factor for cardiovascular death in Asian countries, including Japan. Although stroke is a major cause of death and disability in Japan, few cohort studies have examined the association between BMI and stroke incidence in Japan. This study aimed to examine the association between BMI and stroke incidence using prospective data from Japanese community residents.MethodsData were analyzed from 12,490 participants in the Jichi Medical School Cohort Study. Participants were categorized into five BMI groups: ≤18.5, 18.6–21.9, 22.0–24.9, 25.0–29.9, and ≥30.0 kg/m2. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard model. The group with a BMI of 22.0–24.9 kg/m2 was used as the reference category.ResultsDuring mean follow-up of 10.8 years, 395 participants (207 men and 188 women) experienced stroke, including 249 cerebral infarctions and 92 cerebral hemorrhages. Men with a BMI ≤18.5 kg/m2 (HR 2.11; 95% CI, 1.17–3.82) and women with a BMI ≥30.0 kg/m2 (HR 2.25; 95% CI, 1.28–5.08) were at significantly higher risk for all-stroke. Men with a BMI ≤18.5 kg/m2 were at significantly higher risk for cerebral infarction (HR 2.15; 95% CI, 1.07–4.33).ConclusionsThe association between BMI and stroke incidence observed in this population was different than those previously reported: low BMI was a risk factor for all-stroke and cerebral infarction in men, while high BMI was a risk factor for all-stroke in women.

Highlights

Stroke is a major cause of death and disability in Japan
We examined the association between body mass index (BMI) and stroke incidence in Japanese community residents using data from the Jichi Medical School Cohort Study
A meta-analysis performed by the Japan Atherosclerosis Longitudinal Study group reported a significantly elevated incidence of cerebral infarction and hemorrhage in both sexes with a BMI 27.5 kg/m2, this significance disappeared after adjusting for Systolic blood pressure (SBP).[24]

Summary

Introduction

Stroke is a major cause of death and disability in Japan. Among the Japanese population, the acute case-fatality rate for cerebral infarction is less than 10 percent.[13,14] non-fatal stroke is a major cause of lifelong disability and places a heavy burden on Japan's long-term care insurance system.[15]. Stroke is a major cause of death and disability in Japan, few cohort studies have examined the association between BMI and stroke incidence in Japan. Conclusions: The association between BMI and stroke incidence observed in this population was different than those previously reported: low BMI was a risk factor for all-stroke and cerebral infarction in men, while high BMI was a risk factor for all-stroke in women

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