Dynapenic Abdominal Obesity and the Risk of Stroke in Postmenopausal Women

Stroke is highly prevalent among middle-aged and older adults, posing a significant global health burden. Dynapenic abdominal obesity (DAO), a clinical phenotype integrating dynapenia and abdominal obesity, has been linked to various chronic diseases. However, its association with incident stroke in postmenopausal women remains unexplored. This study aimed to investigate the prospective association between DAO and new-onset stroke in postmenopausal women.

We included 2,654 participants from five waves of the China Health and Retirement Longitudinal Study. Dynapenia was defined as handgrip strength < 18 kg, and abdominal obesity as waist circumference ≥ 85 cm. Participants were categorized into four groups: non-dynapenic/non-abdominally obese (ND/NAO), abdominally obese only (ND/AO), dynapenic only (D/NAO), and DAO (D/AO). Multivariable Cox proportional hazards models were employed to assess the association between DAO and incident stroke.

During a median 9-year follow-up, 309 incident stroke cases were documented. The incidence of stroke was highest in the D/AO group compared to other groups. After adjustment for sociodemographic factors, lifestyle behaviors, and cardiometabolic risk factors,the D/AO group showed a significantly higher risk of stroke compared to the ND/NAO group (HR: 2.341, 95% CI: 1.511-3.628).

The coexistence of dynapenia and abdominal obesity is independently associated with a markedly elevated risk of incident stroke among postmenopausal women. Future research should focus on elucidating the underlying biological mechanisms in more detail and on designing and evaluating interventions specifically aimed at mitigating the stroke risk associated with this critical phenotype.