Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study
Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study
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DOI：
10.2188/jea.je20170298
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发表时间：
2019-09-01
影响因子：
4.7
通讯作者：
Tsugane, Shoichiro
中科院分区：
文献类型：
--
作者：
Li, Yuanying;Yatsuya, Hiroshi;Tsugane, Shoichiro
背景资料：关联的体重指数（BMI）与缺血性中风亚型的风险尚未建立。方法：累计平均BMI计算使用自报的体重和身高从基线（队列I在1990年，队列II从1993-1994年）和5年和10年的问卷调查日本公共卫生中心为基础的前瞻性（JPHC）研究。对40-69岁的42,343名男性和46,413名女性进行了随访，以了解腔隙性、大动脉闭塞性和心源性栓塞性卒中的发生率。一个子分布风险模型被用来估计子分布风险比（SHR）和95%置信区间（CI）。结果：在中位数为20.0年的后续行动，我们记录了809和481腔隙，395和218大动脉闭塞，568和298心源性栓塞中风的男性和女性，分别。校正基线年龄、更新的吸烟、饮酒、闲暇时间体力活动以及高血压、血脂异常和糖尿病史后，累积平均BMI与腔隙性脑梗死呈线性正相关。（趋势P = 0.007），大动脉闭塞（趋势P = 0.002）和心源性（趋势P < 0.001）卒中，女性腔隙性（趋势P < 0.001）和大动脉闭塞性（趋势P = 0.003）卒中。累积平均BMI >= 30 kg/m2的男性和女性发生心源性卒中的风险大约是BMI 23- 30 kg/m2的女性的两倍。
Background: The association of body mass index (BMI) with risks of ischemic stroke subtypes have not been established.Methods: Cumulative average BMI was calculated using self-reported body weight and height obtained from baseline (Cohort I in 1990, and Cohort II from 1993-1994) and 5- and 10-year questionnaire surveys of Japan Public Health Center-based prospective (JPHC) study. A total of 42,343 men and 46,413 women aged 40-69 years were followed-up for the incidence of lacunar, large-artery occlusive, and cardioembolic strokes. A sub-distribution hazard model was used to estimate sub-distribution hazard ratios (SHRs) and the 95% confidence intervals (CIs).Results: During a median of 20.0 years of follow-up, we documented 809 and 481 lacunar, 395 and 218 large-artery occlusive, and 568 and 298 cardioembolic strokes in men and women, respectively. After adjustment for baseline age, updated smoking, alcohol consumption, leisure-time physical activity, and histories of hypertension, dyslipidemia, and diabetes mellitus, cumulative average BMI was positively linearly associated with lacunar (trend P = 0.007), large-artery occlusive (trend P = 0.002), and cardioembolic (trend P < 0.001) strokes in men, and with lacunar (trend P < 0.001) and large-artery occlusive (trend P = 0.003) strokes in women. There were approximately two-fold excess risk of cardioembolic stroke in both sexes and of lacunar and large-artery occlusive strokes in women for cumulative average BMI >= 30 kg/m(2) compared to BMI 23-