Obesity and the Risk of Cryptogenic Ischemic Stroke in Young Adults

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Jaakonmaki N., Zedde M., Sarkanen T., Martinez-Majander N., Tuohinen S., Sinisalo J., ...More

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, vol.31, no.5, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 5
  • Publication Date: 2022
  • Doi Number: 10.1016/j.jstrokecerebrovasdis.2022.106380
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Keywords: Cryptogenic stroke, Ischemic stroke, Obesity, Waist-to-hip ratio, &nbsp, Young adults, TO-HEIGHT RATIO, ADIPOSE-TISSUE, SCREENING TOOL, DISEASE, PREVALENCE, COUNTRIES, BURDEN
  • Istanbul University Affiliated: Yes


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.