Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study
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- Li Yuanying
- Department of Public Health, Fujita Health University
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- Yatsuya Hiroshi
- Department of Public Health, Fujita Health University Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine
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- Iso Hiroyasu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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- Yamagishi Kazumasa
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba
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- Saito Isao
- Program for Nursing and Health Sciences, Ehime University Graduate School of Medicine
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- Kokubo Yoshihiro
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
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- Sawada Norie
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center
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- Tsugane Shoichiro
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center
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<p>Background: The association of body mass index (BMI) with risks of ischemic stroke subtypes have not been established.</p><p>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).</p><p>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/m2 compared to BMI 23–<25 kg/m2.</p><p>Conclusion: Cumulative average BMI showed a positive linear effect on sub-distribution hazards of lacunar, large-artery occlusive, and cardioembolic strokes in both sexes, except for cardioembolic stroke in women.</p>
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ
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Ｊｏｕｒｎａｌ ｏｆ Ｅｐｉｄｅｍｉｏｌｏｇｙ 29 (9), 325-333, 2019-09-05
日本疫学会