This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 40/4/1098    most recent STROKEAHA.108.539692v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Zhang, X. Articles by Zheng, W. Search for Related Content PubMed PubMed Citation Articles by Zhang, X. Articles by Zheng, W. Related Collections Epidemiology

(Stroke. 2009;40:1098.)
© 2009 American Heart Association, Inc.

Go Red for Women

General and Abdominal Adiposity and Risk of Stroke in Chinese Women

Xianglan Zhang, MD, MPH; Xiao-Ou Shu, MD, PhD; Yu-Tang Gao, MD; Gong Yang, MD, MPH; Honglan Li, MD Wei Zheng, MD, PhD

From the Department of Medicine (X.Z., X.-O.S., G.Y., W.Z.), Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, Tenn; and the Department of Epidemiology (Y.-T.G., H.L.), Shanghai Cancer Institute, China.

Correspondence to Xianglan Zhang, MD, MPH, Vanderbilt Epidemiology Center, Institute for Medicine & Public Health, Vanderbilt University Medical Center, Sixth Floor, Suite 600, 2525 West End Avenue, Nashville, TN 37203-1738. E-mail xianglan.zhang{at}vanderbilt.edu

Background and Purpose— Although both general and abdominal adiposity are well-established risk factors for coronary heart disease, their associations with stroke are less well characterized, particularly in generally lean Asian populations.

Methods— We evaluated associations of body mass index (BMI), waist-hip ratio (WHR), waist circumference (WC), and waist-height ratio (WHtR) with stroke risk in the Shanghai Women’s Health Study, a population-based prospective cohort study of 74 942 Chinese women aged 40 to 70 years with anthropometric measurement taken at recruitment in 1996 to 2000. For this analysis, we included 67 083 women with no prior history of stroke, coronary heart disease, rheumatic heart disease, cardiac surgery, or cancer at recruitment. Incident stroke was ascertained by biennial home visits and linkage with vital statistics registries.

Results— Cut points for the highest quintiles of BMI, WHR, WC, and WHtR among this cohort were 26.6 (kg/m²), 0.85 (cm/cm), 84.1 (cm), and 0.54 (cm/cm), respectively. During a mean follow-up of 7.3 years, 2403 incident stroke cases were identified. All selected anthropometric measurements were positively and significantly associated with risk of total, ischemic, and hemorrhagic stroke in a dose-response manner (all probability values for trend <0.01). The multivariable-adjusted hazard ratios (95% confidence intervals) for total stroke comparing the highest versus lowest quintiles of these measurements were 1.71 (1.49 to 1.97), 1.59 (1.37 to 1.85), 1.77 (1.53 to 2.05), and 1.91 (1.61 to 2.27) for BMI, WHR, WC, and WHtR, respectively.

Conclusion— Increasing levels of general or abdominal adiposity consistently predict increased risk of stroke in predominantly nonobese Chinese women.

Key Words: adiposity • stroke • women