ArticleJournal of epidemiology2023
Mediators of the Effect of Obesity on Stroke and Heart Disease Risk: Decomposing Direct and Indirect Effects.
Article in Journal of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 5 citations in OpenAlex.
- Circadian Syndrome Mediates the Association Between Body Roundness Index and Incident Stroke Risk in Middle-Aged and Older Chinese Adults: A Nationwide Prospective Cohort Study.Behavioural neurology · 2026Article
- Association of Type 2 Diabetes and Body Mass Index with Arterial Stiffness: A Carotid Ultrasound Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Association of cumulative changes in atherogenic index of plasma and its obesity-related derivatives with cardiovascular disease: emphasis on incremental risk of diabetes status.Cardiovascular diabetology · 2025Article
- Obesity and Atherosclerotic Cardiovascular Disease: A Review of Social and Biobehavioral Pathways.Methodist DeBakey cardiovascular journal · 2025Review
- Association between the atherogenic index of plasma, body mass index, and cardiovascular diseases in Chinese middle and old-aged adults: a mediation analysis.Frontiers in cardiovascular medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prevalence of overweight and obesity are well known risk factors of atherosclerotic cardiovascular disease (ASCVD). We aimed to examine the association between body mass index (BMI) and ASCVD over a 23-year follow-up in young adults. We also qualified how much of the effects of obesity on ASCVD were mediated through blood pressure, cholesterol, and glucose.
methodsData are from the Korean Life Course Health Study, a cohort study of 226,955 Korean young adults aged 20-39. At baseline, the participants undertook routine health assessments where their BMI was measured in 1992-1994; and the metabolic mediators including systolic blood pressure (SBP), fasting serum glucose (FSG), and total cholesterol (TC) were re-measured in 2002-2004. The main outcomes of the study include incident events of ischemic heart disease (IHD), stroke, and ASCVD between 2005 and 2015. Cox proportional model was used to calculate adjusted hazard ratios (HRs) for ASCVD.
resultsIn both men and women, the direct effect of BMI on ASCVD was greater than the indirect effect. The percentage of excess HR of BMI mediated by all of the metabolic mediators, including SBP, FSG, and TC, was 45.7% for stroke and 18.7% for IHD in men and 27.5% for stroke and 17.6% for IHD in women.
conclusionHigh BMI in young adults increases the risk of metabolic mediators in their middle age, and metabolic mediators explain the adverse effects of high BMI on stroke risk than IHD risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.