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Abdominal and gynoid adiposity and the risk of stroke

Toss, F.; Wiklund, P.; Franks, Paul LU ; Eriksson, M.; Gustafson, Y.; Hallmans, G.; Nordstrom, P. and Nordstrom, A. (2011) In International Journal of Obesity 35(11). p.1427-1432
Abstract
Background: Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke. Methods: A cohort of 2751 men and women aged >= 40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age. Results: During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke... (More)
Background: Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke. Methods: A cohort of 2751 men and women aged >= 40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age. Results: During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR) = 1.66, 95% confidence interval (CI) = 1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR = 0.72, 95% CI = 0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR = 1.49, 95% CI = 1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR = 1.80, 95% CI = 1.06-3.07; HR = 1.71, 95% CI = 1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension. Conclusion: Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors. International Journal of Obesity (2011) 35, 1427-1432; doi: 10.1038/ijo.2011.9; published online 22 February 2011 (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
fat mass, fat distribution, abdominal fat, gynoid fat, stroke, cox, proportional hazard model
in
International Journal of Obesity
volume
35
issue
11
pages
1427 - 1432
publisher
Nature Publishing Group
external identifiers
  • wos:000297156600008
  • scopus:81155135068
ISSN
1476-5497
DOI
10.1038/ijo.2011.9
language
English
LU publication?
yes
id
3eb047fe-d756-47b8-9448-22a9e464c323 (old id 2252756)
date added to LUP
2012-01-02 07:57:29
date last changed
2017-08-20 03:01:03
@article{3eb047fe-d756-47b8-9448-22a9e464c323,
  abstract     = {Background: Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke. Methods: A cohort of 2751 men and women aged >= 40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age. Results: During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR) = 1.66, 95% confidence interval (CI) = 1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR = 0.72, 95% CI = 0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR = 1.49, 95% CI = 1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR = 1.80, 95% CI = 1.06-3.07; HR = 1.71, 95% CI = 1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension. Conclusion: Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors. International Journal of Obesity (2011) 35, 1427-1432; doi: 10.1038/ijo.2011.9; published online 22 February 2011},
  author       = {Toss, F. and Wiklund, P. and Franks, Paul and Eriksson, M. and Gustafson, Y. and Hallmans, G. and Nordstrom, P. and Nordstrom, A.},
  issn         = {1476-5497},
  keyword      = {fat mass,fat distribution,abdominal fat,gynoid fat,stroke,cox,proportional hazard model},
  language     = {eng},
  number       = {11},
  pages        = {1427--1432},
  publisher    = {Nature Publishing Group},
  series       = {International Journal of Obesity},
  title        = {Abdominal and gynoid adiposity and the risk of stroke},
  url          = {http://dx.doi.org/10.1038/ijo.2011.9},
  volume       = {35},
  year         = {2011},
}