Milionis Haralampos J, Rizos Evangelos, Goudevenos John, Seferiadis Konstantinos, Mikhailidis Dimitri P, Elisaf Moses S
Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
Stroke. 2005 Jul;36(7):1372-6. doi: 10.1161/01.STR.0000169935.35394.38. Epub 2005 Jun 2.
Metabolic syndrome (MetSyn) represents a constellation of lipid and nonlipid risk factors for cardiovascular disease and is a recognized target for increased behavioral therapy.
The association between acute ischemic/nonembolic stroke and the MetSyn in elderly individuals was assessed in a population-based case-control study in the prefecture of Ioannina, Greece.
A total of 163 patients aged older than 70 years admitted with first-ever-in-a-lifetime acute ischemic/nonembolic stroke and 166 controls were included.
The prevalence of MetSyn (defined according to NCEP/ATP III criteria) was high in stroke patients (46.0% versus 15.7%, P<0.001). Compared with controls as a group (with and without MetSyn), stroke patients with the MetSyn showed higher concentrations of triglycerides, lipoprotein(a), uric acid, and fibrinogen, and lower high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I levels. In logistic regression analysis, crude and adjusted odd ratios (ORs) for MetSyn were 5.33 (95% confidence interval [CI], 2.91 to 9.79; P<0.0001) and 2.59 (95% CI, 1.24 to 5.42; P=0.012), respectively. The analysis of interaction between MetSyn and its individual components revealed significant associations with abdominal obesity (adjusted OR, 2.74; 95% CI, 1.15 to 6.50; P=0.02), hypertension (OR, 2.03; 95% CI, 0.91 to 4.49; P=0.08), high fasting glucose levels (OR, 2.95; 95% CI, 1.19 to 7.35; P=0.02), high triglyceride (OR, 5.55; 95% CI, 2.71 to 11.37; P<0.0001]), and low HDL cholesterol (OR, 5.42; 95% CI, 2.85 to 10.30; P<0.0001). Notably, in stroke patients with the MetSyn the inverse relationship between HDL cholesterol levels and ischemic stroke was negated (OR, 1.04; 95% CI, 1.02 to 1.05; P<0.0001).
MetSyn is associated with an increased risk for acute ischemic/nonembolic stroke in elderly subjects with significant contributions from its individual components. In the presence of MetSyn, HDL cholesterol loses its protective role against ischemic stroke.
代谢综合征（MetSyn）是心血管疾病的一系列脂质和非脂质危险因素，是强化行为治疗的公认靶点。
在希腊约阿尼纳州进行的一项基于人群的病例对照研究中，评估老年个体急性缺血性/非栓塞性卒中与MetSyn之间的关联。
纳入了163例年龄大于70岁、首次发生急性缺血性/非栓塞性卒中的患者以及166例对照。
卒中患者中MetSyn（根据NCEP/ATP III标准定义）的患病率较高（46.0% 对15.7%，P<0.001）。与对照组（包括有和没有MetSyn的）整体相比，患有MetSyn的卒中患者甘油三酯、脂蛋白(a)、尿酸和纤维蛋白原浓度更高，高密度脂蛋白（HDL）胆固醇和载脂蛋白A-I水平更低。在逻辑回归分析中，MetSyn的粗比值比（OR）和校正后比值比分别为5.33（95%置信区间[CI]，2.91至9.79；P<0.0001）和2.59（95%CI，1.24至5.42；P=0.012）。对MetSyn及其各个组分之间相互作用的分析显示，与腹型肥胖（校正后OR，2.74；95%CI，1.15至6.50；P=0.02）、高血压（OR，2.03；95%CI，0.91至4.49；P=0.08）、高空腹血糖水平（OR，2.95；95%CI，1.19至7.35；P=0.02）、高甘油三酯（OR，5.55；95%CI，2.71至11.37；P<0.0001）以及低HDL胆固醇（OR，5.42；95%CI，2.85至10.30；P<0.0001）存在显著关联。值得注意的是，在患有MetSyn的卒中患者中，HDL胆固醇水平与缺血性卒中之间的负相关关系被消除（OR，1.04；95%CI，1.02至1.05；P<0.0001）。
MetSyn与老年个体急性缺血性/非栓塞性卒中风险增加相关，其各个组分起了重要作用。在存在MetSyn的情况下，HDL胆固醇失去了对缺血性卒中的保护作用。
