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(Stroke. 2008;39:e163.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Metabolic Syndrome and Stroke

U.S. Department of Health and Human Services, Kansas City, Mo

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

In an interesting study of 991 members of a Finnish cohort,¹ Wang et al found that 5 definitions of metabolic syndrome (MS) were associated with the risk of all types of stroke combined, and 3 components of MS—glucose intolerance, insulin resistance and central obesity—were independently associated with stroke. The sixth definition (American College of Endocrinology [ACE] definition) of MS did not include obesity as a component of MS but raised body mass index was regarded as a risk factor for MS.² If Wang et al had restricted their study to ischemic stroke, they might have found MS by ACE definition also to be associated with stroke. Their findings are not surprising because the components of MS (obesity, hypertension, fasting glucose, triglycerides, and HDL-cholesterol) are known risk factors for type 2 diabetes or coronary artery disease and ischemic stroke. However, why is it necessary to combine these risk factors into a syndrome and determine its association with stroke?

The components of MS are pathophysiological parameters, not symptoms, disease states, or disabilities that could be grouped as a syndrome. The underlying pathophysiology of MS and its value as a diagnosis are unclear, and its usefulness as a marker of cardiovascular disease risk above and beyond the risk associated with individual components is uncertain.³ MS is not included in the international classification of diseases (ICD) by any of the 6 definitions. The ICD-9-CM code 277.7 is for dysmetabolic syndrome X defined as a "group of metabolic disorders that are related . . . [Full Text of this Article]