Takahashi Kazuo, Bokura Hirokazu, Kobayashi Shotai, Iijima Kenichi, Nagai Atsushi, Yamaguchi Shuhei
Department of Neurology, Shimane University School of Medicine, Izumo, Japan.
Intern Med. 2007;46(10):643-8. doi: 10.2169/internalmedicine.46.6094. Epub 2007 May 24.
Metabolic syndrome is a characterized by a cluster of cardiovascular risk factors, including visceral obesity, insulin resistance, dyslipidemia, and hypertension. The criteria for diagnosing metabolic syndrome differ among ethnic groups, due in part to differences in eating habits and body build. Little is known about the relationship between metabolic syndrome and ischemic stroke in Asian countries. The aim of this study was to investigate the relationship between metabolic syndrome and first-time ischemic strokes.
SUBJECTS & METHODS: Study subjects were 1,493 Japanese adults aged 55 years-old or older with no diabetes mellitus, no history of stroke and no neurological abnormalities, who participated in a voluntary neurological health screening at the Institute of Shimane Health Science, Japan (767 men, 62.0 +/- 5.9 years old at entry and 726 women, 61.8 +/- 5.1 years old at entry). All subjects were given an annual clinical stroke questionnaire. Clinical details of patients who reported strokes were confirmed with the attending physicians. Each subject was evaluated for an average of 6.4 +/- 3.8 years. Metabolic syndrome was defined using the modified criteria for Japanese population published in April 2005.
Metabolic syndrome was diagnosed in 11.0% of men and 1.1% of women. Adjusting for age and smoking, female subjects with metabolic syndrome had a 23.1-fold increased risk of suffering ischemic strokes [95% confidence interval (CI), 2.7-196], whereas metabolic syndrome did not increase the risk of ischemic stroke in men.
Metabolic syndrome is more likely to influence a risk for ischemic stroke in women than in men.
代谢综合征的特征是一系列心血管危险因素，包括内脏肥胖、胰岛素抵抗、血脂异常和高血压。由于饮食习惯和体型的差异，不同种族诊断代谢综合征的标准有所不同。在亚洲国家，关于代谢综合征与缺血性中风之间的关系知之甚少。本研究的目的是调查代谢综合征与首次缺血性中风之间的关系。
研究对象为1493名55岁及以上的日本成年人，他们没有糖尿病、中风病史和神经异常，在日本岛根健康科学研究所参加了自愿性神经健康筛查（767名男性，入组时年龄为62.0±5.9岁；726名女性，入组时年龄为61.8±5.1岁）。所有受试者每年都接受临床中风问卷调查。报告中风的患者的临床细节由主治医生确认。每位受试者平均接受了6.4±3.8年的评估。代谢综合征采用2005年4月公布的日本人群修正标准进行定义。
男性中11.0%被诊断为代谢综合征，女性中为1.1%。在调整年龄和吸烟因素后，患有代谢综合征的女性受试者患缺血性中风的风险增加了23.1倍[95%置信区间（CI），2.7 - 196]，而代谢综合征并未增加男性患缺血性中风的风险。
与男性相比，代谢综合征更有可能影响女性患缺血性中风的风险。
