title: Measures of adiposity and risk of stroke in China: a result from the Kailuan study.
abstract: OBJECTIVE
  The objective of this study was to explore the association between adiposity and risk of incident stroke among men and women.
  
  
  METHODS
  We studied the relationship between adiposity and stroke among 94,744 participants (18-98 years old) in the Kailuan study. During a follow-up of 4 years, 1,547 ischemic or hemorrhagic strokes were recorded. Measurements of adiposity included body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated from Cox regression models and each model fit was assessed using -2log-likelihood.
  
  
  RESULTS
  Every measurement of adiposity was associated with the risk for total stroke and ischemic stroke, but not for hemorrhagic stroke. After adjusting for confounders and intermediates, the HR (comparing the mean of the highest quintile with that of the lowest quintile) for total stroke was 1.34(1.13-1.60) for BMI, 1.26(1.06-1.52) for WC, 1.29(1.08-1.56) for WHpR, and 1.38(1.15-1.66) for WHtR. The HR for ischemic stroke was 1.52(1.24-1.88) for BMI, 1.46(1.17-1.81) for WC, 1.40(1.12-1.74) for WHpR, and 1.62(1.29-2.04) for WHtR. The model fit for each of the indices was similar.
  
  
  CONCLUSIONS
  Adiposity increases the total risk of stroke and ischemic stroke, but not of hemorrhagic stroke. No clinically meaningful differences among the associations between BMI, WC, WHpR, and WHtR and stroke incidence were identified in this study.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Anxin
authors.initials: A
authors.lastname: Wang
authors.forename: Jianwei
authors.initials: J
authors.lastname: Wu
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Guo
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Luo
authors.forename: Shouling
authors.initials: S
authors.lastname: Wu
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002545:Brain Ischemia / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology*; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D055815:Young Adult