Association of General and Abdominal Obesity and their Changes with Stroke in Chinese Adults: Results from an 11.8-year Follow-up Study

Abstract Background and Aims Obesity-related diseases play a significant role in the epidemiology of stroke; however, the exact effects of obesity and transitions in obesity status on stroke risk are still unclear. This study was performed to investigate the association of general and abdominal obesity and their changes with stroke in Chinese adults. Methods and Results A total of 26815 subjects (13684 men and 13131 women) aged ≥35 years participated in the study. The association of general and abdominal obesity and their changes with stroke were estimated by Cox proportional hazards models. During a median follow-up period of 11.8 years, 1507 people developed an incident stroke event. The multivariable-adjusted hazard ratios (HRs) (95% CIs) for stroke comparing the highest vs. lowest quartiles of these measurements were 1.276 (1.068–1.524) for BMI, 1.245 (1.035–1.499) for WC, 0.940 (0.786–1.125) for WHR, and 1.221 (1.019–1.464) for WHtR in men. For women, the corresponding values were 1.368 (1.089–1.718), 1.424 (1.119–1.813), 0.971 (0.765–1.232), and 1.341 (1.059–1.699), respectively. C- statistics showed no difference in the predictive value for stroke among various measures of adiposity. Compared with participants who maintained a normal BMI, participants with incident obesity, reversed obesity, or persistent obesity displayed an increased risk of stroke. Similar results were found for WC. Conclusion Increasing levels of general or abdominal adiposity consistently predict increased risk of stroke and changes in BMI or WC, whether a gain or a loss, could increase the risk for stroke.