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Paul Franks

Paul Franks

Principal investigator

Paul Franks

Abdominal and gynoid adiposity and the risk of stroke


  • F. Toss
  • P. Wiklund
  • Paul Franks
  • M. Eriksson
  • Y. Gustafson
  • G. Hallmans
  • P. Nordstrom
  • A. Nordstrom

Summary, in English

Background: Previous studies have indicated that fat distribution is important in the development of cardiovascular disease (CVD). We investigated the association between fat distribution, as measured by dual energy X-ray absorptiometry (DXA), and the incidence of stroke. Methods: A cohort of 2751 men and women aged >= 40 years was recruited. Baseline levels of abdominal, gynoid and total body fat were measured by DXA. Body mass index (BMI, kg m(-2)) was calculated. Stroke incidence was recorded using the regional stroke registry until subjects reached 75 years of age. Results: During a mean follow-up time of 8 years and 9 months, 91 strokes occurred. Of the adiposity indices accessed abdominal fat mass was the best predictor of stroke in women (hazard ratio (HR) = 1.66, 95% confidence interval (CI) = 1.23-2.24 per standard deviation increase), whereas the ratio of gynoid fat to total fat mass was associated with a decreased risk of stroke (HR = 0.72, 95% CI = 0.54-0.96). Abdominal fat mass was the only of the adiposity indices assessed that was found to be a significant predictor of stroke in men (HR = 1.49, 95% CI = 1.06-2.09). The associations between abdominal fat mass and stroke remained significant in both women and men after adjustment for BMI (HR = 1.80, 95% CI = 1.06-3.07; HR = 1.71, 95% CI = 1.13-2.59, respectively). However, in a subgroup analyses abdominal fat was not a significant predictor after further adjustment for diabetes, smoking and hypertension. Conclusion: Abdominal fat mass is a risk factor for stroke independent of BMI, but not independent of diabetes, smoking and hypertension. This indicates that the excess in stroke risk associated with abdominal fat mass is at least partially mediated through traditional stroke risk factors. International Journal of Obesity (2011) 35, 1427-1432; doi: 10.1038/ijo.2011.9; published online 22 February 2011


  • Genetic and Molecular Epidemiology
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year







International Journal of Obesity





Document type

Journal article


Nature Publishing Group


  • Nutrition and Dietetics


  • fat mass
  • fat distribution
  • abdominal fat
  • gynoid fat
  • stroke
  • cox
  • proportional hazard model



Research group

  • Genetic and Molecular Epidemiology


  • ISSN: 1476-5497