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(Stroke. 2008;39:1036.)
© 2008 American Heart Association, Inc.

Research Letters

Metabolic Syndrome and Its Components as Predictors of Ischemic Stroke in Type 2 Diabetic Patients

Ioannis Protopsaltis, MD; Panagiotis Korantzopoulos, MD; Haralampos J. Milionis, MD; Anastasios Koutsovasilis, MD; Georgios K. Nikolopoulos, PhD; Eftihia Dimou, MD; Stelios Kokkoris, MD; Paris Brestas, MD; Moses S. Elisaf, MD Andreas Melidonis, MD

From the Diabetes Center (I.P., E.D., S.K., P.B., A.M.), ‘Tzanio’ General Hospital of Piraeus, Greece; Department of Cardiology (P.K.), School of Medicine, University of Ioannina, Greece; Department of Internal Medicine (H.J.M., M.S.E.), School of Medicine, University of Ioannina, Greece; Hellenic Centre for Diseases Control and Prevention (G.K.N.), Athens, Greece.

Correspondence to Haralampos Milionis, MD, Assistant Professor of Internal Medicine, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece. E-mail hmilioni{at}cc.uoi.gr

Abstract

Background and Purpose— The available data regarding the association between metabolic syndrome (MS) or MS components and ischemic stroke in type 2 diabetics are limited and inconsistent. This study aimed to investigate these associations.

Methods— Five hundred ninety-nine consecutive type 2 diabetic patients (mean age 60.4±9.6 years, 54% men) were followed-up for 10.1 years (median period). Baseline clinical and laboratory characteristics and the occurrence of a first-ever ischemic stroke during follow-up were recorded.

Results— Seventy-eight patients developed a first-ever ischemic stroke. According to Cox proportional hazard model, waist circumference (hazard ratio, HR:1.006, 95% CI:1.002 to 1.010, P=0.003) and age (HR:1.061, 95% CI:1.002 to 1.125, P=0.04) were significant predictors. After incorporating various combinations of MS components in multivariate models, only age and waist circumference remained significant.

Conclusions— MS per se at baseline or combinations of its components do not predict the development of ischemic stroke in type 2 diabetic patients. Waist circumference represents an independent prognostic factor and could be used as a clinical tool for stroke prevention in this population.

Key Words: ischemic stroke • metabolic syndrome • risk factors • type 2 diabetes