the SECRETO Study Group, Jaakonmäki, Nina, Zedde, Marialuisa, Sarkanen, Tomi, Martinez-Majander, Nicolas, Tuohinen, Suvi, Sinisalo, Juha, Ryödi, Essi, Autere, Jaana, Hedman, Marja, Junttola, Ulla, Huhtakangas, Jaana K., Grimaldi, Teresa, Pascarella, Rosario, Nordanstig, Annika, Bech-Hanssen, Odd, Holbe, Christine, Busch, Raila, Fromm, Annette, Ylikotila, Pauli, Turgut, Esme Ekizoglu, Amorim, Isabel, Ryliskiene, Kristina, Tulkki, Lauri, Pascasio, Laura Amaya, Licenik, Radim, Ferdinand, Phillip, Tsivgoulis, Georgios, Jatužis, Dalius, Kõrv, Liisa, Kõrv, Janika, Pezzini, Alessandro, Fonseca, Ana Catarina, Yesilot, Nilufer, Roine, Risto O., Waje-Andreassen, Ulrike, von Sarnowski, Bettina, Redfors, Petra, Huhtakangas, Juha, Numminen, Heikki, Jäkälä, Pekka, Putaala, Jukka, Tampere University, Department of Neurosciences and Rehabilitation, Clinical Medicine, TAYS Heart Centre, HUS Neurocenter, Neurologian yksikkö, HUS Heart and Lung Center, Department of Medicine, Clinicum, University of Helsinki, Kardiologian yksikkö, Department of Neurosciences, and Repositório da Universidade de Lisboa
© 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), 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., The study was funded by the Helsinki and Uusimaa Hospital District, Academy of Finland, University of Helsinki, and Sahlgrenska University Hospital.