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Association between different obesity measures and the risk of stroke in the EPIC Spanish cohort

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Abstract

Introduction

There is still a scientific debate on the exact role played by obesity on stroke risk.

Objective

The aim of the study was to analyze the association between obesity, measured by different indices such as body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and a new one called A Body Shape Index (ABSI) and the risk of total and ischemic stroke.

Subjects/methods

A total of 41,020 subjects (15,490 men and 25,530 women) aged 29–69 years participated in the study. All participants were recruited between 1992 and 1996 and followed up until 2008 to ascertain incident cerebrovascular disease events. Cox proportional hazards models were designed to estimate the relative risk and 95 % CI between obesity and cerebrovascular disease incidence.

Results

After 13.8 years of follow-up, a total of 674 stroke cases (55.3 % in men) were registered (531 ischemic, 79 hemorrhagic, 42 subarachnoid hemorrhage and 22 unspecified). WC fourth quartile (HR 1.95; 95 % CI 1.20–3.19) and WHR fourth quartile (HR 1.58; 95 % CI 1.12–2.25) were positively associated with total stroke only in men. BMI was not associated with stroke incidence. The new index, ABSI, was significantly associated with total stroke incidence only in men (HR 1.54; 95 % CI 1.06–2.23).

Conclusions

Data from the Spanish EPIC cohort study show a strong association of WC and WHR with the relative risk of suffering a stroke only in men, while no associations were found for BMI. It supports the suggestion of other authors of using more than one obesity index in the study of stroke risk prediction.

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Acknowledgments

The authors would like to thank the participants in the Spanish EPIC cohort for their contribution to this study as well as the team who participated in the recruitment and the two Doctors Maite Martinez Zabaleta and Fermin Moreno Izco from Donostia Hospital for their collaboration in the validation process. Itziar Abete is grateful to the Health Institute Carlos III for the financial support through a Sara Borrell postdoctoral contract. This work was supported by the Spanish Ministry of Health (ISCIII RETICC RD06/0020); Spanish Regional Governments of Andalusia, Asturias, Basque Country, Murcia (No 6236) and Navarra and the Catalan Institute of Oncology.

Conflict of interest

All the authors declare not having conflicts of interest.

Author information

Authors and Affiliations

  1. Neuroscience Department, Health Research Institute Biodonostia, Po Doctor Begiristain, San Sebastian, 20014, Spain

    Itziar Abete, Estibaliz Goyenechea, Adolfo Lopez de Munain & Maite Martinez

  2. Public Health Department of Gipuzkoa, Basque Government, Donostia-San Sebastian, Spain

    Larraitz Arriola, Nerea Etxezarreta, Imanol Mozo, Pilar Amiano & Miren Dorronsoro

  3. Public Health Institute of Navarra, Pamplona, Spain

    Conchi Moreno-Iribas, Eva Ardanaz & Aurelio Barricarte

  4. Red de Investigación en Servicios Sanitarios en Enfermedades Crónicas, Bilbao, Spain

    Conchi Moreno-Iribas

  5. Health Research Institute Biodonostia, Donostia University Hospital, San Sebastian, Spain

    Nerea Egüés

  6. Pharmacists´ Official School of Gipuzkoa, San Sebastian, Spain

    Estibaliz Goyenechea

  7. Neurology Department, Donostia University Hospital, San Sebastian, Spain

    Adolfo Lopez de Munain & Maite Martinez

  8. Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain

    Noemi Travier

  9. Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain

    Carmen Navarro, Maria-Dolores Chirlaque, Maria-Jose Tormo, Diana Gavrila & Jose Maria Huerta

  10. CIBER Epidemiologia y Salud Pública (CIBERESP), San Sebastian, Spain

    Carmen Navarro, Maria-Dolores Chirlaque, Maria-Jose Tormo, Diana Gavrila, Jose Maria Huerta, María-José Sánchez, Esther Molina-Montes, Eva Ardanaz & Aurelio Barricarte

  11. Department of Health and Social Sciences, University of Murcia, Murcia, Spain

    Carmen Navarro & Maria-Jose Tormo

  12. Andalusian School of Public Health, Health Research Institute of Granada, Granada, Spain

    María-José Sánchez, Esther Molina-Montes & Mar Requena

  13. University Hospital Virgen del Rocio, Sevilla, Spain

    Maria-Dolores Jiménez-Hernández

  14. Public Health and Planning Directorate, Asturias, Spain

    Jose Ramon Quiros & Laudina Rodriguez

Authors
  1. Itziar Abete
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  16. Jose Maria Huerta
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  17. María-José Sánchez
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Corresponding author

Correspondence to Itziar Abete.

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Abete, I., Arriola, L., Etxezarreta, N. et al. Association between different obesity measures and the risk of stroke in the EPIC Spanish cohort. Eur J Nutr 54, 365–375 (2015). https://doi.org/10.1007/s00394-014-0716-x

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  • DOI: https://doi.org/10.1007/s00394-014-0716-x

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