Anthropometric Measurements in Predicting Haemorrhagic Stroke Among Bangladeshi Population: The MAGPIE Study

Redoy Ranjan,1,2 Dipannita Adhikary,1 Gie Ken-Dror,1 Md Abdullah Yusuf,3 Adneen Moureen,4 Maliha Hakim,5 Pankaj Sharma1,6 1Department of Biological Sciences, Royal Holloway University of London, London, UK; 2Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 3Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh; 4Tuberculosis New Technologies and Diagnostics, USAID’s, Dhaka, Bangladesh; 5Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh; 6Department of Clinical Neuroscience, Imperial College Healthcare NHS Trust, London, UKCorrespondence: Pankaj Sharma, Department of Biological Sciences, Royal Holloway University of London, London, UK, Email [email protected]: Anthropometric measurements used to predict cardiovascular disease vary worldwide but are mostly derived from those of Caucasian ancestry. We sought to undertake such measurements in the little studied Bangladeshi population.Methods: The MAGPIE (Multidimensional Approach of Genotype and Phenotype in Stroke Etiology) study is a Bangladeshi stroke case–control study that recruited nationwide between January 2022 and June 2024. The univariate analysis was utilised to curtail the risk of independent variables, and a receiver operating characteristic (ROC) curve was employed to identify the cut-off values of Body Mass Index (BMI), Waist Circumference (WC), and Hip Circumference (HC). Furthermore, a multivariate logistic regression (LR) model demonstrated the risk of independent predictors of haemorrhagic stroke (HS) among sexes.Results: Of a total of 1491 age- and sex-matched study population, 918 were haemorrhagic stroke (61.5%) with female predominance (n=489; 53.3%) and significantly older than men (P=0.003). The BMI (22.9 ± 3.0 vs 21.3 ± 3.0; P< 0.001), WC (84.0 ± 7.3 vs 80.8 ± 7.3; P< 0.001) and HC (90.6 ± 7.1 vs 85.5 ± 7.7; P< 0.001) was significantly higher among women compared to men. A ROC curve demonstrated that the cut-off values of BMI, WC, and HC are 20.6kg/m2, 78.8cm, and 84.6cm, respectively, in men and 21.1 kg/m2, 81.5cm, and 88.1cm, respectively, in women haemorrhagic stroke population. Furthermore, an age-adjusted multivariate LR model identified a HC of ≥ 84.6 cm in men (OR 2.8, 95% CI 1.61– 4.97; P < 0.001) and a WC of ≥ 81.5cm in women (OR 1.6, 95% CI 1.01– 2.37; P=0.001) as potential independent predictors of haemorrhagic stroke.Conclusion: Bangladeshi men with a hip circumference of ≥ 84.6cm have about threefold, and women with a waist circumference of ≥ 81.1cm have about twofold heightened risk of haemorrhagic stroke.Keywords: haemorrhagic stroke, body mass index, waist circumference, hip circumference, Bangladesh