title: Obesity and Abdominal Fat Markers in Patients with a History of Stroke and Transient Ischemic Attacks.
abstract: BACKGROUND
  Abdominal obesity is a well-recognized cardiovascular risk factor. Conflicting data concerning its significance with respect to stroke have been discussed in recent years. The objective of this study was to analyze the association between anthropometric parameters and the risk of stroke and transient ischemic attacks (TIAs) in German primary care.
  
  
  METHODS
  Patient recruitment in this large-scale epidemiological study was performed in 3188 representative primary care offices in Germany. Among 6980 study participants, 1745 patients with a history of stroke or TIA were identified and matched for age and gender with 5235 regional controls. Associations between standard anthropometric measures such as body mass index (BMI), waist-to-hip ratio, waist circumference, waist-to-height ratio, and cerebrovascular risk were investigated using logistic regression analysis with adjustment for age, gender, and vascular risk factors.
  
  
  RESULTS
  BMI showed no significant associations with the risk of stroke or TIA in any of the applied mathematical models. Markers of abdominal obesity were associated with an increased risk of stroke or TIA in the unadjusted model (waist circumference: odds ratio [OR] 1.15; 95% confidence interval [CI], 1.00-1.32; waist-to-hip ratio: OR 1.21; 95% CI, 1.05-1.38; waist-to-height ratio: OR 1.25; 95% CI, 1.09-1.44, comparisons between top and bottom tertiles). After adjustment for vascular risk factors, all associations were insignificant.
  
  
  CONCLUSIONS
  Abdominal obesity is a stronger predictor of risk of stroke or TIA than BMI. However, the association between abdominal obesity and the risk of stroke or TIA is not independent of other vascular risk factors. Stroke-related weight changes should be considered in longitudinal studies examining the role of obesity in cerebrovascular disease.
authors.affiliation: Department of Neurology, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany. Electronic address: yaroslav.winter@unimedizin-mainz.de.
authors.forename: Yaroslav
authors.initials: Y
authors.lastname: Winter
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Pieper
authors.affiliation: Epidemiology Unit, German Rheumatism Research Centre Berlin, A Leibniz Institute, Berlin, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Klotsche
authors.affiliation: Department Clinical Epidemiology, Leibniz-Institute of Prevention Research and Epidemiology, Bremen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Riedel
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology*; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods*; D019540:Area Under Curve; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*; D055105:Waist Circumference; D049629:Waist-Hip Ratio
keywords: Stroke; abdominal obesity; body mass index; risk factors; transient ischemic attack