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Bardugo A, Fishman B, Libruder C, et al. Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke. 2021;52(6):2043-2052doi: 10.1161/STROKEAHA.120.033595.
Bardugo, A., Fishman, B., Libruder, C., Tanne, D., Ram, A., Hershkovitz, Y., Zucker, I., Furer, A., Gilon, R., Chodick, G., Tiosano, S., Derazne, E., Tzur, D., Afek, A., Pinhas-Hamiel, O., Bendor, C. D., Yaniv, G., Rotem, R. S., & Twig, G. (2021). Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke, 52(6), 2043-2052. https://doi.org/10.1161/STROKEAHA.120.033595
Bardugo, Aya, et al. "Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood." Stroke vol. 52,6 (2021): 2043-2052. doi: https://doi.org/10.1161/STROKEAHA.120.033595
Bardugo A, Fishman B, Libruder C, Tanne D, Ram A, Hershkovitz Y, Zucker I, Furer A, Gilon R, Chodick G, Tiosano S, Derazne E, Tzur D, Afek A, Pinhas-Hamiel O, Bendor CD, Yaniv G, Rotem RS, Twig G. Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood. Stroke. 2021 Jun;52(6):2043-2052. doi: 10.1161/STROKEAHA.120.033595. Epub 2021 May 13. PMID: 33980044.
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Stroke. 2021 Jun;52(6):2043-2052. doi: 10.1161/STROKEAHA.120.033595. Epub 2021 May 13.

Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood.

Stroke

Aya Bardugo, Boris Fishman, Carmit Libruder, David Tanne, Amit Ram, Yael Hershkovitz, Inbar Zucker, Ariel Furer, Roy Gilon, Gabriel Chodick, Shmuel Tiosano, Estela Derazne, Dorit Tzur, Arnon Afek, Orit Pinhas-Hamiel, Cole Daniel Bendor, Gal Yaniv, Ran Shmuel Rotem, Gilad Twig

Affiliations

  1. Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan (A.B., B.F., A.F., R.G., E.D., D. Tzur, C.D.B., G.T.).
  2. Hypertension Unit, Internal Medicine D (B.F.), Sheba Medical Center, Ramat Gan, Israel.
  3. The Dr. Pinchas Bornstein Talpiot Medical Leadership Program (B.F., G.Y., G.T.), Sheba Medical Center, Ramat Gan, Israel.
  4. Sackler Faculty of Medicine, Tel Aviv University, Israel (B.F., I.Z., G.C., S.T., E.D., A.A., O.P.-H., G.Y., G.T.).
  5. Israel Center for Disease Control, Ministry of Health, Ramat Gan (C.L., A.R., Y.H., I.Z.).
  6. Rambam Health Care Campus and Rappaport Faculty of Medicine, Haifa, Israel (D. Tanne).
  7. Maccabitech (G.C.), Maccabi Healthcare Services, Tel Aviv, Israel.
  8. Division of Cardiology, Leviev Heart and Vascular Center (S.T.), Sheba Medical Center, Ramat Gan, Israel.
  9. Central Management (A.A.), Sheba Medical Center, Ramat Gan, Israel.
  10. Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital (O.P.-H.).
  11. Department of Diagnostic Imaging (G.Y.).
  12. Kahn-Sagol-Maccabi Research and Innovation Institute (R.S.R.), Maccabi Healthcare Services, Tel Aviv, Israel.
  13. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA (R.S.R.).
  14. Institute of Endocrinology (G.T.).

PMID: 33980044 DOI: 10.1161/STROKEAHA.120.033595

Abstract

BACKGROUND AND PURPOSE: There is a continuous rise in the prevalence of adolescent obesity and incidence of stroke among young adults in many Western countries, but the association between them is unclear.

METHODS: A nationwide population-based study of 1 900 384 Israeli adolescents (58% men; mean age, 17.3 years) who were evaluated before mandatory military service during 1985 and 2013. Body mass index was classified according to the US Center for Disease Control and Prevention percentiles. Primary outcome was a first stroke event as recorded by the Israeli National Stroke Registry between 2014 and 2018. Cox proportional hazard models were applied.

RESULTS: There were 1088 first stroke events (921 ischemic and 167 hemorrhagic; mean diagnosis age, 41.0 years). Adolescent body mass index was significantly associated with a graded increase in the risk for any stroke, ischemic stroke, but less so with hemorrhagic stroke. The hazard ratios for the first ischemic stroke event were 1.4 (95% CI, 1.2–1.6), 2.0 (95% CI, 1.6–2.4), and 3.4 (95% CI, 2.7–4.3) for the 50th to 84th percentile, overweight and obese groups, respectively, after adjustment for sex, age, and sociodemographic confounders with the 5th to 49th body mass index percentile group as the reference. The respective hazard ratios after further adjustment for diabetes status were 1.3 (1.1–1.5), 1.6 (1.3–2.0), and 2.4 (1.9–3.1). Results persisted when the cohort was divided by diabetes status and when ischemic stroke before age 30 was the outcome.

CONCLUSIONS: High adolescent body mass index was associated with ischemic stroke in young adults with or without diabetes. The rising prevalence of adolescent obesity may increase the future burden of stroke in young adults.

Keywords: adolescent; body mass index; ischemic stroke; obesity; overweight; stroke; young adult

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