Body fat distribution and risk of incident ischemic stroke in men and women aged 50 to 74 years from the general population. The KORA Augsburg cohort study

Zahn, Karl; Linseisen, Jakob; Heier, Margit; Peters, Annette; Thorand, Barbara; Nairz, Franziska; Meisinger, Christa

doi:10.1371/journal.pone.0191630

Cited by 26 publications

(17 citation statements)

References 41 publications

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“…Comparing the four anthropometric indexes and identifying the index that was most closely related to stroke were very important for the primary prevention of stroke in Jilin province. A similar study explored the association between body fat distribution and the risk of incident ischemic stroke (28). Their results showed that waist circumference or waist-to-height ratio was superior to BMI in predicting the risk of ischemic stroke.…”

Section: Figure 1 | Association Between Stroke and Bmi Quartiles (A)mentioning

confidence: 99%

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

et al. 2019

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Background: Stroke is a leading cause of long-term adult disability and death in China, and primary prevention is essential for stroke. The aim of this study is to compare the four anthropometric indexes (body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio) and identify the index that is most closely related to stroke in areas with high incidence of stroke. Methods: A total of 4,052 participants aged 40 years or older were selected by the multistage stratified cluster sampling method in Dehui City in Jilin province, China. Face-to-face interviews and physical examinations were conducted to collect the participants' information. Descriptive data analyses were conducted. Multivariable logistic analyses were used to explore the adjusted association between stroke and body fat measuring indexes. Results: For body mass index (adjusted odds ratio (OR): 1.13, 95% confident interval (CI): 0.77-1.65), waist circumference (adjusted OR: 1.32, 95% CI: 0.88-1.99), and waist-to-hip ratio (adjusted OR: 1.34, 95% CI: 0.92-1.93), the patients in the highest quartile did not have a higher risk of stroke than those in the lowest quartile. For waist-to-height ratio, the patients in the highest quartile were more likely have a stroke than those in the lowest quartile (adjusted OR: 1.81, 95% CI: 1.16-2.82). The area under the curve of waist-to-height ratio, waist-to-hip ratio, waist circumference, and body mass index for stroke were 0.

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Section: Figure 1 | Association Between Stroke and Bmi Quartiles (A)mentioning

confidence: 99%

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

et al. 2019

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“…In addition, by using diet- or genetic-induced obesity, the body and vasculature of the animal is still young, rather than middle aged. These points are critically significant because obesity may be more common in aging women and may confer greater risk for secondary health issues such as ischemic stroke ( 1 , 4 , 5 , 8 , 9 ).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the menopausal transition is associated with a significant increase in body weight and abdominal fat in middle-aged females ( 7 ). In addition, studies suggest that abdominal obesity may contribute to a greater risk for ischemic stroke in women than in men ( 1 , 8 , 9 ). The reasons for the sex differences in obesity and risk of stroke in middle-aged men and women are not fully understood.…”

Section: Introductionmentioning

confidence: 99%

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Sex Differences in Adipose Tissue CD8+ T Cells and Regulatory T Cells in Middle-Aged Mice

et al. 2018

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The prevalence of cardiovascular disease has increased among middle-aged women in the United States, yet has declined in middle-aged men. In experimental stroke, middle-aged females have larger strokes and greater inflammation than age-matched males or younger females. The mechanism underlying this shift from an “ischemia-protected” to an “ischemia-sensitive” phenotype in aging females is unknown. One potential factor is an age-related increase in systemic factors that induce inflammation. Increased abdominal fat deposition is seen in women during middle age. Adipose tissue plays a key role in obesity-induced systemic inflammation, including increased pro-inflammatory cytokines. We hypothesized that age and sex differences in adipose immune cells promote an augmented pro-inflammatory milieu in middle-aged females driven by a balance shift between pro-inflammatory and anti-inflammatory T cells. Abdominal adipose tissue immune cells from young (3–4 months) and middle-aged (15–16 months) male and female C57BL/6J mice were analyzed by flow cytometry. Plasma triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were determined with colorimetric assays. Middle-aged mice had higher adipose tissue mass compared to young mice. Lipid profiling showed no sex differences in TG and LDL, but middle-aged females had lower HDL (0.84 ± 0.07 μg/μl) than middle-aged males (1.35 ± 0.06 μg/μl). Flow cytometry data demonstrated an age-associated increase in adipose tissue CD8+ T cells that was augmented by female sex, with middle-aged females having a higher percentage of CD8+ cells (34.4 ± 3.2% of CD3+ T cells) than middle-aged males (24.4 ± 2.2%). This increase in CD8+ T-cell proportion was adipose tissue-specific, as this change was not observed in blood. Middle-aged females had higher numbers of activated (CD69+) CD8+ T cells than males. In addition, female CD8+ T cells produced higher levels of IFN-γ, TNF-α, and granzyme B ex vivo, and females had higher adipose levels of IFN-γ, RANTES and MIP-1β than middle-aged males. In parallel, females had lower levels of regulatory T cells (Tregs), an anti-inflammatory T-cell subtype, compared to age-matched males. In conclusion, middle-aged females have a detrimental combination of elevated pro-inflammatory T cells and decreased anti-inflammatory Tregs in adipose tissue, which may promote a pro-inflammatory milieu and contribute to increased cardiovascular disease burden in aging females.

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“…However, BMI as a stroke risk predictor has its limitations. A prospective population-based study published in 2018 by Zahn et al [7] showed that BMI is not associated with the incidence of ischemic stroke. A similar result was obtained by Seung-Han Suk et al [8], in which BMI was not significantly associated with ischemic stroke incidence.…”

Section: Introductionmentioning

confidence: 99%

Does obesity increase the risk of stroke?

Sajdak¹,

Stępień²,

Werel³

et al. 2019

Med Og Nauk Zdr.

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Introduction.According to the World Health Organization (WHO), about 15 million people worldwide suffer from stroke each year, which makes it the second leading cause of death and the leading cause of acquired disability in adults. Obesity is considered to be a great risk factor for stroke. It appears to play a role in the functional outcome and mortality. Obesity can be expressed by many indicators. Most commonly used is Body Mass Index (BMI). Objective. The aim of the study is to determine whether obesity increases the risk of stroke and present the recent state of knowledge about predictors for stroke incidence. Brief description of the state of knowledge. It seems that BMI cannot be taken into consideration as an isolated risk factor for stroke. BMI limitations create a need for better obesity indicators. Recently, it was highlighted that abdominal obesity and its indicators might be a better predictor for stroke incidence compared to BMI. This seems reasonable if recent studies are taken into account in which it was found that abdominal fat has more metabolic activity than subcutaneous fat. Conclusions. The use of the alternative obesity measurements, such as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), could help to correct limitations linked to the BMI, especially regarding patients with visceral type of obesity. All three obesity markers (BMI, WHR and WHtR) should be considered for use in every day practice. Key wordsstroke, abdominal obesity, risk factors, body mass index Streszczenie Wprowadzenie. Według Światowej Organizacji Zdrowia każdego roku ok. 15 mln ludzi na całym świecie cierpi z powodu udaru, co czyni go drugą najczęstszą przyczyną śmierci i główną przyczyną nabytej niepełnosprawności u dorosłych. Otyłość jest uważana za istotny czynnik ryzyka udaru mózgu, prawdopodobnie mający również wpływ na rokowanie oraz śmiertelność poudarową. Otyłość można zmierzyć za pomocą wielu wskaźników, przy czym najczęściej stosowanym jest wskaźnik masy ciała (ang. Body Mass Index, BMI). Cel pracy. Celem pracy jest określenie, czy otyłość zwiększa ryzyko wystąpienia udaru, i przedstawienie aktualnego stanu wiedzy na temat wskaźników ryzyka wystąpienia udaru. Opis stanu wiedzy. Wydaje się, że BMI nie może być brane pod uwagę jako izolowany czynnik ryzyka udaru. Ograniczenia związane ze stosowaniem BMI stwarzają potrzebę poszukiwania lepszych wskaźników otyłości. W ostatnich latach podkreśla się, że otyłość brzuszna i jej markery mogą stanowić bardziej wiarygodne wskaźniki ryzyka udaru mózgu w porównaniu do BMI. Uzasadniają to ostatnie badania, w których stwierdzono, że tłuszcz brzuszny ma większą aktywność metaboliczną niż podskórna tkanka tłuszczowa. Podsumowanie. Zastosowanie innych wskaźników otyłości, takich jak stosunek obwodu talii do obwodu bioder (ang. waist-to-hip ratio, WHR) oraz stosunek obwodu talii do wzrostu (ang. waist-to-height ratio, WHtR), może pomóc w skorygowaniu ograniczeń BMI, szczególnie w przypadku pacjentów z otyłością brzuszną. Wydaje się, że w celu najdokładniejszego określ...

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Body fat distribution and risk of incident ischemic stroke in men and women aged 50 to 74 years from the general population. The KORA Augsburg cohort study

Cited by 26 publications

References 41 publications

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

Comparison of the Four Anthropometric Indexes and Their Association With Stroke: A Population-Based Cross-Sectional Study in Jilin Province, China

Sex Differences in Adipose Tissue CD8+ T Cells and Regulatory T Cells in Middle-Aged Mice

Does obesity increase the risk of stroke?

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