Objectives
The pieces of evidence regarding whether metabolic syndrome (MetS) is a better predictor
than its individual components, especially diabetes, for recurrent stroke are limited.
This study aimed to examine these associations.
Methods
A total of 1087 ischemic stroke patients were recruited consecutively from 2003 to
2004. They were followed up until the end of 2008. Baseline clinical and laboratory
characteristics and new stroke event during follow-up were recorded. MetS was defined
by the definition issued by the Chinese Medical Association/Chinese Diabetes Society.
Results
One hundred forty-three new stroke cases were recorded. After adjusting for baseline
age, gender, education, marriage status, subtype stroke, length of index stroke to
baseline assessment, history of cardiac diseases, smoking status, drinking status,
clinics, aspirin treatment, and fibrinogen by Cox regression models, the risk of recurrent
stroke was 43% higher in MetS patients than in non-MetS patients (hazard ratio [HR] = 1.43,
95% confidence interval [CI]: 1.01-2.01). The strength of this association is weaker
than MetS individual components such as elevated glycemia (adjusted HR = 1.78, 95%
CI: 1.26-2.52), elevated blood pressure (adjusted HR = 1.91, 95% CI: 1.11-3.30), or
low high-density lipoprotein cholesterol (adjusted HR = 1.57, 95% CI: 1.08-2.51).
Compared with the group with neither MetS nor diabetes, the adjusted risk of recurrent
stroke was highest in the group with diabetes (HR = 2.77, 95% CI: 1.66-4.63), followed
by those with both MetS and diabetes (HR = 1.91, 95% CI: 1.25-2.94). The risk of recurrent
stroke in patients with MetS in the absence of diabetes was similar to those with
neither.
Conclusion
MetS is not superior to its individual components in predicting future recurrent stroke
in patients who experience mild-to-moderate ischemic stroke.
Key Words
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Article info
Publication history
Published online: December 24, 2015
Accepted:
November 14,
2015
Received in revised form:
November 5,
2015
Received:
July 27,
2015
Footnotes
The paper has 6 authors, all of whom have made substantial contributions to the work. Dr. Xiang-Hua Fang and Dr. Xunming Ji are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Xiang-Hua Fang, the first author, also helped run the study, analyzed and interpreted the data, and drafted this paper. Dr. Xun-ming Ji and Dr. Xin-qing Zhang have made major contributions to the conception, design, and implementation of the study. Drs. Hong-Jun Liu, Hong-mei Zhang, and Xiao-ming Qin collected the data and visited patients. Drs. Xin-Qing Zhang, Xiao-Ming Qin, and Xun-Ming Ji diagnosed and classified stroke subtypes. Drs. Xiang-hua Fang and Xun-ming Ji provided the final approval of this revision.
Source of funding: This study was supported by a grant from the Capital Health Research and Development of Special (CHRDS) (grant number: CHRDS 2014-1-1031).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.017
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
