title: Risk of incident ischemic stroke according to the metabolic health and obesity states in the Vascular-Metabolic CUN cohort.
abstract: Background Whether obesity is a major risk factor for cardiovascular disease in the absence of metabolic comorbidities remains under debate. Indeed, some obese individuals may be at low risk of metabolic-related complications, while normal-weight individuals may not be "healthy." Aims To assess the incidence of ischemic stroke according to the metabolic health and obesity states of 5171 participants from the Vascular-Metabolic CUN cohort. Methods A Cox proportional-hazard analysis was conducted to estimate the hazard ratio and their 95% confidence interval of stroke according to the metabolic health and obesity states based on TyG index and Adult Treatment Panel-III criteria, during 9.1 years of follow-up. Results After 50,056.2 person-years of follow-up, 162 subjects developed an ischemic stroke (incidence rate 3.23 per 1000 person-years). Metabolically healthy obese subjects did not show greater risk of stroke, while metabolically unhealthy participants, obese and non-obese, had an increased risk of stroke, compared with healthy non-obese. The hazard ratios for the multivariable adjusted model were 1.55 (95% CI: 1.36-1.77) and 1.86 (95% CI: 1.57-2.21), respectively. Conclusions Metabolically unhealthy individuals exhibited a greater risk of ischemic stroke than metabolically healthy obese individuals.
authors.affiliation: 1 Hospital Garcia Orcoyen, Navarra, Spain.|2 Centro de Salud de Burlada, Navarra, Spain.|3 University of Navarra.
authors.forename: Laura
authors.initials: L
authors.lastname: Sánchez-Iñigo
authors.affiliation: 1 Hospital Garcia Orcoyen, Navarra, Spain.|3 University of Navarra.
authors.forename: David
authors.initials: D
authors.lastname: Navarro-González
authors.affiliation: 3 University of Navarra.|4 Department of Occupational Medicine, University of Navarra Clinic, Pamplona, Spain.|5 Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Fernández-Montero
authors.affiliation: 3 University of Navarra.|6 Department of Internal Medicine, University of Navarra Clinic, Pamplona, Spain.|7 IdiSNA, Pamplona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Pastrana-Delgado
authors.affiliation: 3 University of Navarra.|7 IdiSNA, Pamplona, Spain.|8 Centre for Nutrition Research, Food Science and Physiology, University of Navarra, Pamplona, Spain.|9 Centro de Investigación Biomédica en Red de Fiosiopatología de la Obesidad y Nutrición (CIBERObn), Instituto CarlosIII, Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Martínez
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology*; D044465:White People
keywords: Obesity; cerebrovascular disease; hypertriglyceridemia; insulin resistance; ischemic stroke; metabolic syndrome