| Title: | Predictive Value of Traditional and Novel Obesity Indices for Stroke and Its Subtypes Across Sexes and Glucose Status: Toward Precision Prevention Strategies. |
| Journal: | Journal of the American Heart Association |
| Published: | 10 Mar 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41804920/ |
| DOI: | https://doi.org/10.1161/jaha.125.043083 |
| URL: | http://dx.doi.org/10.1161/jaha.125.043083 |
Publication 17424
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Abstract
BACKGROUND: This study compared the predictive capacity of traditional and novel obesity indices for stroke subtype risks across sexes and glucose metabolic statuses, addressing limitations of current anthropometric tools.</p>
METHODS: A retrospective cohort of 398 270 UK Biobank participants who were stroke free was analyzed. Eight novel indices-weight-adjusted waist index, a body shape index, body roundness index, visceral adiposity index, conicity index, lipid accumulation product, waist-to-hip ratio, and waist-to-height ratio-were compared with traditional measures (body mass index, waist circumference). Cox proportional hazards and Fine-Gray competing risk models generated hazard ratios (HRs) with 95% CIs, stratified by sex and glucose status. Predictive discrimination was assessed via Harrell's C-statistic.</p>
RESULTS: Novel indices outperformed traditional metrics for total and ischemic stroke. Weight-adjusted waist index showed the strongest associations: men in the highest quartile had a 25% increased ischemic stroke risk (HR, 1.25 [95% CI, 1.11-1.36]); women had a 36% increased risk (HR, 1.36 [95% CI, 1.20-1.57]). For ischemic stroke prediction, weight-adjusted waist index significantly surpassed body mass index in both sexes (C-statistics: men, 0.712 [95% CI, 0.705-0.720] versus body mass index, 0.688 [95% CI, 0.680-0.696], P<0.0001; women, 0.748 [95% CI, 0.739-0.757] versus body mass index, 0.726 [95% CI, 0.717-0.735], P=0.0007). No significant associations were observed for hemorrhagic stroke.</p>
CONCLUSIONS: Weight-adjusted waist index exceeds conventional obesity metrics in predicting cerebrovascular events, with robust performance across sexes and glucose-regulated populations. Findings support sex-specific adiposity assessment in stroke prevention, particularly for ischemic subtypes in normoglycemic individuals.</p>
19 Keywords
- Adiposity
- Aged
- Blood Glucose
- Body Mass Index
- Female
- Humans
- Ischemic Stroke
- Male
- Middle Aged
- Obesity
- Predictive Value of Tests
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Sex Factors
- Stroke
- United Kingdom
- Waist Circumference
- Waist-Hip Ratio
5 Authors
- Fang Li
- Zhi-Yun Wang
- Sha-Sha Qi
- Yu-Ming Xu
- Chang-He Shi
Enabling scientific discoveries that improve human health