Obesity and the Risk of Cryptogenic Ischemic Stroke in Young Adults

Nina Jaakonmäki(University of Eastern Finland), Marialuisa Zedde(Azienda Sanitaria Unità Locale di Reggio Emilia), Tomi Sarkanen(Tampere University Hospital), Nicolas Martinez‐Majander(University of Helsinki), Suvi Tuohinen(University of Helsinki), Juha Sinisalo(University of Helsinki), Essi Ryödi(Tampere University Hospital), Jaana Autere(University of Eastern Finland), Marja Hedman(Kuopio University Hospital), Ulla Junttola(Oulu University Hospital), Jaana K. Huhtakangas(Oulu University Hospital), Teresa Grimaldi Capitello(Azienda Sanitaria Unità Locale di Reggio Emilia), Rosario Pascarella(Azienda Sanitaria Unità Locale di Reggio Emilia), Annika Nordanstig(University of Gothenburg), Odd Bech‐Hanssen(National Academy of Medicine), Christine Holbe(Universitätsmedizin Greifswald), Raila Busch(Universitätsmedizin Greifswald), Annette Fromm(Haukeland University Hospital), Pauli Ylikotila(University of Turku), Esme Ekizoğlu Turgut(Istanbul University), Isabel Amorim(University of Lisbon), Kristina Ryliškienė(Vilnius University), Lauri Tulkki(University of Helsinki), Laura Amaya‐Pascasio(University of Almería), Radim Líčeník(Peterborough City Hospital), Phillip Ferdinand(Royal Stoke University Hospital), Georgios Tsivgoulis(National and Kapodistrian University of Athens), Dalius Jatužis(Vilnius University), Liisa Kõrv(University of Tartu), Janika Kõrv(University of Tartu), Alessandro Pezzini(University of Brescia), Ana Catarina Fonseca(University of Lisbon), Nilüfer Yeşilot(Istanbul University), Risto O. Roine(University of Turku), Ulrike Waje‐Andreassen(Haukeland University Hospital), Bettina von Sarnowski(Universitätsmedizin Greifswald), Petra Redfors(University of Gothenburg), Juha Huhtakangas(Oulu University Hospital), Heikki Numminen(Tampere University Hospital), Pekka Jäkälä(University of Eastern Finland), Jukka Putaala(University of Helsinki)
Journal of Stroke and Cerebrovascular Diseases
February 18, 2022
10.1016/j.jstrokecerebrovasdis.2022.106380
Cited by 32Open Access
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Abstract

OBJECTIVES: We examined the association between obesity and early-onset cryptogenic ischemic stroke (CIS) and whether fat distribution or sex altered this association. MATERIALS AND METHODS: This prospective, multi-center, case-control study included 345 patients, aged 18-49 years, with first-ever, acute CIS. The control group included 345 age- and sex-matched stroke-free individuals. We measured height, weight, waist circumference, and hip circumference. Obesity metrics analyzed included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), and a body shape index (ABSI). Models were adjusted for age, level of education, vascular risk factors, and migraine with aura. RESULTS: After adjusting for demographics, vascular risk factors, and migraine with aura, the highest tertile of WHR was associated with CIS (OR for highest versus lowest WHR tertile 2.81, 95%CI 1.43-5.51; P=0.003). In sex-specific analyses, WHR tertiles were not associated with CIS. However, using WHO WHR cutoff values (>0.85 for women, >0.90 for men), abdominally obese women were at increased risk of CIS (OR 2.09, 95%CI 1.02-4.27; P=0.045). After adjusting for confounders, WC, BMI, WSR, or ABSI were not associated with CIS. CONCLUSIONS: Abdominal obesity measured with WHR was an independent risk factor for CIS in young adults after rigorous adjustment for concomitant risk factors.

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