title: Contribution of obesity and abdominal fat mass to risk of stroke and transient ischemic attacks.
abstract: OBJECTIVE
  Waist circumference has been shown to be a better predictor of cardiovascular risk than body mass index (BMI). Our case-control study aimed to evaluate the contribution of obesity and abdominal fat mass to the risk of stroke and transient ischemic attacks (TIA).
  
  
  METHODS
  We recruited 1137 participants: 379 cases with stroke/TIA and 758 regional controls matched for age and sex. Associations between different markers of obesity (BMI, waist-to-hip ratio, waist circumference and waist-to-stature ratio) and risk of stroke/TIA were assessed by using conditional logistic regression adjusted for other risk factors.
  
  
  RESULTS
  BMI showed a positive association with cerebrovascular risk which became nonsignificant after adjustment for physical inactivity, smoking, hypertension, and diabetes (odds ratio 1.18; 95% CI, 0.77 to 1.79, top tertile versus bottom tertile). Markers of abdominal adiposity were strongly associated with the risk of stroke/TIA. For the waist-to-hip ratio, adjusted odds ratios for every successive tertile were greater than that of the previous one (2nd tertile: 2.78, 1.57 to 4.91; 3rd tertile: 7.69, 4.53 to 13.03). Significant associations with the risk of stroke/TIA were also found for waist circumference and waist-to-stature ratio (odds ratio 4.25, 2.65 to 6.84 and odds ratio 4.67, 2.82 to 7.73, top versus bottom tertile after risk adjustment, respectively).
  
  
  CONCLUSIONS
  Markers of abdominal adiposity showed a graded and significant association with risk of stroke/TIA, independent of other vascular risk factors. Waist circumference and related ratios can better predict cerebrovascular events than BMI.
authors.affiliation: Department of Neurology, Klinikum Mannheim, University of Heidelberg, Germany.
authors.forename: Yaroslav
authors.initials: Y
authors.lastname: Winter
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Jakob
authors.initials: J
authors.lastname: Linseisen
authors.forename: Oliver
authors.initials: O
authors.lastname: Lanczik
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ringleb
authors.forename: Johannes
authors.initials: J
authors.lastname: Hebebrand
authors.forename: Tobias
authors.initials: T
authors.lastname: Back
mesh_terms: D050153:Abdominal Fat / Q000473:pathology*; D000328:Adult; D000368:Aged; D001827:Body Height; D015992:Body Mass Index; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology*; D009929:Organ Size; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference