Measures of adiposity and risk of stroke in China: a result from the Kailuan study

PLoS One. 2013 Apr 17;8(4):e61665. doi: 10.1371/journal.pone.0061665. Print 2013.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Brain Ischemia / epidemiology
  • China / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / physiopathology*
  • Waist Circumference
  • Waist-Hip Ratio
  • Young Adult

Grant support

This research was supported by a grant from the National Natural Science Foundation of China (Grant No. 81202279). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.