The metabolic syndrome as predictor of incident stroke
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This prospective population-based study was aimed to investigate the relationship of the metabolic syndrome and its single components with stroke. Metabolic syndrome was defined by the following 6 definitions: World Health Organization (WHO), European Group for the Study of Insulin Resistance (EGIR), National Cholesterol Education Program (NCEP), American College of Endocrinology, International Diabetes Federation (IDF), and American Heart Association. A total of 991 Finnish subjects, aged 65 to 74 years, without diabetes at baseline, participated in the study and were followed-up for 14 years. Cox regression analysis revealed that the metabolic syndrome as defined by 5 definitions (excepting that of the American College of Endocrinology) was significantly associated with stroke. This relationship remained robust even after excluding subjects with myocardial infarction. When excluding patients with myocardial infarction, the following single components of the metabolic syndrome were predictors of stroke: impaired glucose tolerance (WHO and American College of Endocrinology criteria), insulin resistance (EGIR criteria), and central obesity (NCEP criteria). In conclusion, the study results show that the metabolic syndrome and certain of its components, as defined by 5 out of 6 proposed definitions, were significant predictors of incident stroke in elderly subjects.
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