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Body fat distribution, obesity, overweight and stroke incidence in women and men: the NHANES I Epidemiologic Follow-up Study

Abstract

OBJECTIVE: To test the hypothesis that an elevated ratio of subscapular to triceps skinfold thickness (SFR), a measure of truncal obesity, is associated with increased incidence of stroke independent of overweight.

DESIGN: Data from the NHANES I Epidemiologic Follow-up Study were analyzed.

SUBJECTS: A cohort of 3652 women and 3284 men with complete data who had no history of stroke at baseline in 1971–1975.

MEASUREMENTS: Incidence of stroke diagnosed at hospital discharge or death during the follow-up period through 1992; triceps and subscapular skinfold thickness (SSF) and body mass index (BMI) at baseline.

RESULTS: In a complex relationship, higher SFR was associated with a mildly but significantly increased incidence of stroke only in white male former smokers. In white men, SSF showed a U-shaped association with stroke risk. In white men, stroke risk was elevated in the top quartile of BMI only in never smokers. In black women, stroke risk was significantly elevated in the bottom compared to the top quartile of BMI. No significant associations were seen in white women or black men.

CONCLUSIONS: In white men, SSF showed a U-shaped association with stroke risk, which was elevated in the top quartile of BMI only in never smokers. Surprisingly, stroke risk was elevated in black women with the lowest BMI. More studies of these associations are needed, especially in black women.

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Acknowledgements

The NHANES I Epidemiologic Follow-up Study has been developed and funded by these agencies: National Center for Health Statistics; National Institute on Aging; National Cancer Institute; National Institute of Child Health and Human Development; National Heart, Lung and Blood Institute; National Institute of Mental Health; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institute of Allergy and Infectious Diseases; National Institute of Neurological and Communicative Disorders and Stroke; Centers for Disease Control; US Department of Agriculture. The field work was conducted by Westat Inc. (contract numbers 233-80-2049 and 282-84-2111).

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Appendix

Appendix

Sex and race-specific cut-off points for quartiles of ratio of subscapular to triceps skinfold, subscapular skinfold and body mass index

SFR

White men: 1,<1.07; 2, 1.07–1.32; 3, 1.33–1.69; 4,>1.69.

White women: 1,<0.60; 2, 0.60–0.79; 3, 0.80–0.99; 4,>0.99.

Black men: 1,<1.25; 2, 1.25–1.54; 3, 1.55–1.99; 4,>1.99.

Black women: 1,<0.81; 2, 0.81–0.99; 3, 1.00–1.21; 4,>1.21.

SSF

White men: 1,<11.0; 2, 11.0–14.9; 3, 15.0–20.9; 4,>20.9.

White women: 1,<12.5; 2, 12.5–18.9; 3, 19.0–25.9; 4,>25.9.

Black men: 1,<8.5; 2, 8.5–13.9; 3, 14.0–21.9; 4,>21.9.

Black women: 1,<16.0; 2, 16.0–24.9; 3, 25.0–33.4; 4,>33.4.

BMI

White men: 1,<23.2; 2, 23.2–25.6; 3, 25.7–27.8; 4,>27.8.

White women: 1,<22.5; 2, 22.5–25.2; 3, 25.3–28.9; 4,>28.9.

Black men: 1,<21.8; 2, 21.8–24.5; 3, 24.6–27.9; 4,>27.9.

Black women: 1,<24.1; 2, 24.1–27.4; 3, 27.5–32.2; 4,>32.2.

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Gillum, R., Mussolino, M. & Madans, J. Body fat distribution, obesity, overweight and stroke incidence in women and men: the NHANES I Epidemiologic Follow-up Study. Int J Obes 25, 628–638 (2001). https://doi.org/10.1038/sj.ijo.0801590

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