Body mass index exhibited a non-linear association with stroke risk in middle-aged and elderly Chinese men, with each 1 kg/m2 increase below 25.94 kg/m2 increasing stroke risk by 7.6% (HR 1.076).
Cohort (n=12,161)
Yes
Is there a non-linear dose-response relationship between body mass index and stroke risk in middle-aged and elderly Chinese individuals?
BMI has a non-linear relationship with stroke risk in middle-aged and elderly Chinese men, with a saturation effect above 25.94 kg/m2, suggesting strict weight control below this threshold may significantly reduce stroke risk.
Effect estimate: HR 1.025 (95% CI 1.010-1.040)
p-value: p=<0.001
Objective Body mass index (BMI) and stroke risk have been linked, but these findings are still debated. This study investigated the relationship between BMI and stroke risk in a middle-aged and elderly Chinese population. Methods This study used four waves of CHARLS data (2011, 2013, 2015, and 2018), including 12,161 participants. The CHARLS sample was obtained by multi-stage probability sampling and all participants were assessed by one-to-one interviews using a standardized questionnaire. We used a Cox proportional-hazards regression model to examine the relationship between BMI and stroke risk. We used Cox proportional hazards regression with cubic spline functions and smooth curve fitting to identify the non-linear relationship between them. A series of sensitivity analyses were also conducted. Results The multivariate Cox proportional hazards regression model identified a positive association between BMI and stroke risk (HR=1.025, 95% CI: 1.010-1.040). We also found a non-linear relationship between BMI and stroke incidence, with an inflection point at 26.63 kg/m 2 for BMI. Each 1 kg/m 2 increase in BMI to the left of the inflection point was related to a 4.4% increase in stroke risk (HR=1.044, 95% CI: 1.019-1.069). We stratified individuals by gender to further investigate their association and found a particular non-linear relationship and saturation effect between BMI and stroke risk in men, with the inflection point at 25.94 kg/m 2 . Each 1 kg/m 2 increase in BMI to the left of the inflection point was related to a 7.6% increase in stroke risk (HR=1.076, 95% CI 1.034-1.119). The association was linear in women, with each 1 kg/m 2 increase in BMI associated with a 2.1% increase in stroke risk (HR=1.021, 95% CI 1.002, 1.040). Conclusion In men, there was a specific non-linear association and saturation effect of BMI with stroke (inflection point of 25.94 kg/m 2 ), while in women, there was none. When males had a BMI below 25.94 kg/m 2 , the risk of stroke was significantly and positively associated with BMI. By controlling BMI below 25.94 kg/m 2 in men, a further decrease in BMI may promote a significant reduction in stroke risk.
Wei et al. (Wed,) conducted a cohort in Stroke (n=12,161). Body mass index was evaluated on Incident stroke (HR 1.025, 95% CI 1.010-1.040, p=<0.001). Body mass index exhibited a non-linear association with stroke risk in middle-aged and elderly Chinese men, with each 1 kg/m2 increase below 25.94 kg/m2 increasing stroke risk by 7.6% (HR 1.076).
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