title: Adiposity, adipokines, and risk of incident stroke in older men.
abstract: OBJECTIVE
  The association between adiposity and adipocytes and risk of stroke in older adults is uncertain. We have examined the association between adiposity measures and adipocytes (adiponectin and leptin) with incident stroke events in older men.
  
  
  METHODS
  Prospective study of 3411 men aged 60 to 79 years with no previous diagnosis of myocardial infarction, heart failure, or stroke followed-up for an average of 9 years, during which there were 192 incident major stroke events.
  
  
  RESULTS
  In age-adjusted analyses, body mass index and waist circumference were not significantly associated with risk of stroke in older men, although obese men (body mass index >30 kg/m(2)) showed the lowest risk of stroke. Despite the strong positive correlation between leptin and body mass index and waist circumference, risk of stroke was significantly increased in those in the top quartile of the leptin distribution. The increased risk remained after adjustment for potential confounders, including systolic blood pressure (adjusted hazard ratios top quartile versus bottom quartile: 2.03; confidence interval, 1.27-3.27]). Further adjustment for markers of inflammation (c-reactive protein), endothelial dysfunction (von Willebrand factor), fibrinolytic activity (d-dimer), and γ-glutamyl transferase attenuated the increased risk, but risk remained significantly increased (adjusted hazard ratios, 1.73; confidence interval, 1.06-2.83]). By contrast, no association was seen between adiponectin and risk of stroke.
  
  
  CONCLUSIONS
  Conventional adiposity measures were not associated with increased stroke risk in older men. However, leptin (a good marker of percent fat mass), but not adiponectin, predicted stroke, suggesting a link between fat mass and stroke risk.
authors.affiliation: Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill St, London NW32PF, UK. g.wannamethee@ucl.ac.uk
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.forename: A Gerald
authors.initials: AG
authors.lastname: Shaper
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
mesh_terms: D054392:Adipokines / Q000097:blood; D052242:Adiponectin / Q000097:blood*; D050154:Adiposity / Q000502:physiology*; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin