Table 11.
Abdominal Obesity and Stroke in Women and Men
| First Author | Study Site | No. of Subjects | Follow-up, y | Study Type | End Point | Stroke Subtypes | Measure of Abdominal Obesity | HR or OR (95% CI) | |
|---|---|---|---|---|---|---|---|---|---|
| Women | Men | ||||||||
| Hu300 | Finland | 49996 | Mean: 19.5 | Prospective cohort | Clinically defined stroke* | Ischemic, hemorrhagic | WC 4th vs 1st quartile WHR 4th vs 1st quartile |
HR: 1.25 (0.78–2.01) HR: 1.07 (0.70–1.63) |
HR: 1.57 (1.10–2.25) HR: 1.55 (1.06–2.26) |
| Winter307 | Germany | 1137 | Undefined | Case-control | Clinically defined stroke, TIA† | Ischemic, hemorrhagic | F: WC ≥88 cm vs <80 cm M: WC>102 cm vs <94 cm F: WHR ≥0.85 vs <0.85 M: WHR ≥ 1.0 vs <1.0 |
OR: 4.49 (2.13–9.46) OR: 7.77 (3.87–15.61) |
OR: 3.71 (2.18–6.32) OR: 4.13 (2.70–6.30) |
| Suk312 | USA | 1718 | ≈4 | Case-control | Clinically defined stroke‡ | Ischemic | F: WHR ≥0.86 vs <0.86 M: WHR ≥0.93 vs <0.93 | OR: 2.6 (1.7–4.2) | OR: 3.2 (1.9–5.5) |
| Yatsuya301 | USA | 13549 | Median: 16.9 | Prospective cohort | Clinically defined stroke§ | Ischemic | WC 5th vs 1st quintile WHR 5th vs 1st quintile |
Black HR: 1.65(1.03–2.65) White HR: 1.97(1.23–3.15) Black HR: 2.45(1.55–3.87) White HR: 1.76 (1.08–2.88) |
Black HR: 3.19(1.53–6.67) White HR: 2.15(1.14–4.03) Black HR: 1.69(0.91–3.15) White HR: 2.55 (1.42–4.57) |
| Zhang303 | China | 67083 | Mean: 7.3 | Prospective cohort | Clinically defined stroke‖ | Ischemic, hemorrhagic | WC 5th vs 1st quintile WHR 5th vs 1st quintile WSR 5th vs 1st quintile |
HR: 1.77 (1.53–2.05) HR: 1.59 (1.37–1.85) HR: 1.91 (1.61–2.27) |
NA NA NA |
| Lu304 | Sweden | 33578 | Mean: 11 | Prospective cohort |
Clinically defined stroke¶ | Ischemic, hemorrhagic | WC 4th vs 1st quartile WHR ≥0.88 5th vs 1st quintile WSR 5th vs 1st quintile |
HR: 2.3 (1.2–4.3) HR: 2.4 (1.3–4.2) HR: 2.5 (1.5–4.3) |
NA NA NA |
| Furukawa313 | Japan | 5474 | Mean: 11.7 | Prospective cohort | Clinically defined stroke# | Not stated | WC 4th vs 1st quartile | HR: 2.64 (1.16–6.03) | HR: 1.40(0.82–2.41) |
CI indicates confidence interval; HR, hazard ratio; F, female; M, male; NA, not applicable; OR, odds ratio; TIA, transient ischemic attack; WC, waist circumference; WHR, waist-hip ratio; and WSR, waist-to-stature ratio.
Adjusted for age; study year; smoking; physical activity; education level; family history of stroke; alcohol, vegetable, fruit, sausage, and bread consumption; systolic blood pressure; total cholesterol level; and history of diabetes mellitus.
Matehed for age and sex and adjusted for physical inactivity, smoking, history of hypertension, and history of diabetes mellitus.
Matched by age, sex, and race/ethnicity, and adjusted for hypertension, diabetes mellitus, any cardiac disease, current smoking status, no physical activity, moderate alcohol drinking, level of LDL cholesterol, level of HDL cholesterol, and education.
Adjusted for age, education, smoking status, cigarette-years, usual alcohol consumption, and physical activity.
Adjusted for age; education; occupation; family income; menopausal status; use of oral contraceptives; hormone therapy; aspirin; amount of exercise; cigarette smoking; alcohol consumption; and intakes of saturated fat, vegetables, fruits, and sodium comparing the highest versus lowest quintiles.
Adjusted for age, smoking, alcohol intake, age at first birth, years of education, and ever use of oral contraceptives by the time of cohort enrollment.
Adjusted for age, smoking, and drinking status.