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Published Online
on January 31, 2008

Stroke. 2008
Published online before print January 31, 2008, doi: 10.1161/STROKEAHA.107.498311
A more recent version of this article appeared on March 1, 2008
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*Diabetes
*Metabolic Syndrome
*Stroke
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Right arrow Type 2 diabetes
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Submitted on July 4, 2007
Accepted on August 14, 2007

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; and 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.

* To whom correspondence should be addressed. E-mail: hmilioni{at}cc.uoi.gr.

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






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