Kurl Sudhir, Laukkanen Jari A, Niskanen Leo, Laaksonen David, Sivenius Juhani, Nyyssönen Kristiina, Salonen Jukka T
Research Institute of Public Health, University of Kuopio, Kuopio, Finland.
Stroke. 2006 Mar;37(3):806-11. doi: 10.1161/01.STR.0000204354.06965.44. Epub 2006 Feb 9.
The metabolic syndrome, a clustering of disturbed glucose and insulin metabolism, obesity and abdominal fat distribution, dyslipidemia, and hypertension is associated with cardiovascular diseases. The aim of this study was to examine the relationship of metabolic syndrome, as defined by National Cholesterol Education Program (NCEP) and World Health Organization (WHO) criteria, with the risk for stroke.
Population-based cohort study with an average follow-up of 14.3 years from eastern Finland. A total of 1131 men with no history of cardiovascular disease and diabetes at baseline participated. Sixty-five strokes occurred, of which 47 were ischemic strokes.
Men with the metabolic syndrome as defined by the NCEP criteria had a 2.05-fold (95% CI, 1.03 to 4.11; P=0.042) risk for all strokes and 2.41-fold (95% CI, 1.12 to 5.32; P=0.025) risk for ischemic stroke, after adjusting for socioeconomic status, smoking, alcohol, and family history of coronary heart disease. Additional adjustment for ischemic changes during exercise test, serum low-density lipoprotein cholesterol, plasma fibrinogen, energy intake for saturated fats, energy expenditure of leisure time physical activity, and white blood cell count, the results remained significant. The risk ratios among men with metabolic syndrome as defined by the WHO criteria were 1.82 (95% CI, 1.01 to 3.26; P=0.046) for all strokes and 2.16 (95% CI, 1.11 to 4.19; P=0.022) for ischemic stroke. After further adjustment, the respective risks were 2.08 (95% CI, 1.12 to 3.87; P=0.020) and 2.47 (95% CI, 1.21 to 5.07; P=0.013).
The risk of any stroke is increased in men with metabolic syndrome, in the absence of stroke, diabetes and cardiovascular disease at baseline. Prevention of the metabolic syndrome presents a great challenge for clinicians with respect to stroke.
代谢综合征是一种由葡萄糖和胰岛素代谢紊乱、肥胖及腹部脂肪分布异常、血脂异常和高血压聚集而成的症候群，与心血管疾病相关。本研究旨在探讨按照美国国家胆固醇教育计划（NCEP）和世界卫生组织（WHO）标准定义的代谢综合征与中风风险之间的关系。
基于芬兰东部人群的队列研究，平均随访14.3年。共有1131名基线时无心血管疾病和糖尿病病史的男性参与。发生了65例中风，其中47例为缺血性中风。
按照NCEP标准定义的代谢综合征男性发生所有中风的风险为2.05倍（95%可信区间，1.03至4.11；P = 0.042），发生缺血性中风的风险为2.41倍（95%可信区间，1.12至5.32；P = 0.025），在校正社会经济地位、吸烟、饮酒和冠心病家族史后。在进一步校正运动试验期间的缺血性改变、血清低密度脂蛋白胆固醇、血浆纤维蛋白原、饱和脂肪的能量摄入、休闲时间体力活动的能量消耗和白细胞计数后，结果仍然显著。按照WHO标准定义的代谢综合征男性发生所有中风的风险比为1.82（95%可信区间，1.01至3.26；P = 0.046），发生缺血性中风的风险比为2.16（95%可信区间，1.11至4.19；P = 0.022）。进一步校正后，相应风险分别为2.08（95%可信区间，1.12至3.87；P = 0.020）和2.47（95%可信区间，1.21至5.07；P = 0.013）。
在基线时无中风、糖尿病和心血管疾病的男性中，代谢综合征会增加任何中风的风险。对于临床医生而言，预防代谢综合征对中风预防构成了巨大挑战。
