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Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Association between metabolic syndrome and multiple lesions of intracranial atherothrombotic stroke: a hospital-based study

Authors: Kazuhiko Kotani, Noriko Satoh-Asahara, Takuya Nakakuki, Hajime Yamakage, Akira Shimatsu, Tetsuya Tsukahara

Published in: Cardiovascular Diabetology | Issue 1/2015

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Abstract

Background

With the increasing trend of metabolic syndrome (MetS) and atherothrombotic stroke (which can manifest as stroke lesion multiplicity), studies on the association between MetS and the clinical aspects of atherothrombotic stroke are of great interest. The present study aimed to investigate the association between MetS and multiple atherothrombotic strokes in patients with intracranial atherothrombotic stroke.

Methods

A retrospective study based on medical charts was conducted among patients (n = 202: 137 men/65 women) who were symptomatically admitted to the hospital with the first-ever atherothrombotic stroke. For the occurrence of multiple lesions of stroke, odds ratio [OR: 95 % confidence interval (CI)] of MetS or its respective components was calculated using logistic regression models.

Results

Fifty-one percent of the men and 38 % of women with stroke presented multiple regions. MetS was a significant factor that was associated with an increased risk of multiple regions in women [OR 4.3 (95 % CI 1.4–13.5)], but not in men. According to the components of MetS, dyslipidemia was a significant factor that was positively associated with multiple regions in both men [OR 2.0 (95 % CI 1.1–3.7)] and women [OR 3.2 (95 % CI 1.1–9.1)].

Conclusion

MetS may be pathophysiologically associated with intracranial atherothrombotic stroke multiplicity in women in particular. Future studies are warranted to confirm the findings.
Literature
1.
go back to reference Expert Panel on Detection (2001) Evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19):2486–2497CrossRef Expert Panel on Detection (2001) Evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285(19):2486–2497CrossRef
2.
go back to reference Examination Committee of Criteria for ‘Obesity Disease’ in Japan (2002) Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J 66(11):987–992CrossRef Examination Committee of Criteria for ‘Obesity Disease’ in Japan (2002) Japan Society for the Study of Obesity. New criteria for ‘obesity disease’ in Japan. Circ J 66(11):987–992CrossRef
3.
go back to reference Norrving B, Kissela B (2013) The global burden of stroke and need for a continuum of care. Neurology 80(3 Suppl 2):S5–S12CrossRefPubMed Norrving B, Kissela B (2013) The global burden of stroke and need for a continuum of care. Neurology 80(3 Suppl 2):S5–S12CrossRefPubMed
4.
go back to reference Mehndiratta MM, Khan M, Mehndiratta P, Wasay M (2014) Stroke in Asia: geographical variations and temporal trends. J Neurol Neurosurg Psychiatry 85(12):1308–1312CrossRefPubMed Mehndiratta MM, Khan M, Mehndiratta P, Wasay M (2014) Stroke in Asia: geographical variations and temporal trends. J Neurol Neurosurg Psychiatry 85(12):1308–1312CrossRefPubMed
5.
go back to reference Bang OY (2006) Intracranial atherosclerotic stroke: specific focus on the metabolic syndrome and inflammation. Curr Atheroscler Rep 8(4):330–336CrossRefPubMed Bang OY (2006) Intracranial atherosclerotic stroke: specific focus on the metabolic syndrome and inflammation. Curr Atheroscler Rep 8(4):330–336CrossRefPubMed
6.
go back to reference Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119(10):812–819CrossRefPubMed Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119(10):812–819CrossRefPubMed
7.
go back to reference Li W, Ma D, Liu M, Liu H, Feng S, Hao Z et al (2008) Association between metabolic syndrome and risk of stroke: a meta-analysis of cohort studies. Cerebrovasc Dis 25(6):539–547CrossRefPubMed Li W, Ma D, Liu M, Liu H, Feng S, Hao Z et al (2008) Association between metabolic syndrome and risk of stroke: a meta-analysis of cohort studies. Cerebrovasc Dis 25(6):539–547CrossRefPubMed
8.
go back to reference Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P et al (2010) The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 56(14):1113–1132CrossRefPubMed Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P et al (2010) The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 56(14):1113–1132CrossRefPubMed
10.
go back to reference Osborn MF, Miller CC, Badr A, Zhang J (2014) Metabolic syndrome associated with ischemic stroke among the Mexican Hispanic population in the El Paso/US-Mexico border region. J Stroke Cerebrovasc Dis 23(6):1477–1484PubMedCentralCrossRefPubMed Osborn MF, Miller CC, Badr A, Zhang J (2014) Metabolic syndrome associated with ischemic stroke among the Mexican Hispanic population in the El Paso/US-Mexico border region. J Stroke Cerebrovasc Dis 23(6):1477–1484PubMedCentralCrossRefPubMed
11.
go back to reference Uchiyama S (2005) Impact of metabolic syndrome as a risk factor for atherothrombotic stroke. Intern Med 44(10):1021–1022CrossRefPubMed Uchiyama S (2005) Impact of metabolic syndrome as a risk factor for atherothrombotic stroke. Intern Med 44(10):1021–1022CrossRefPubMed
12.
go back to reference Bang OY, Kim JW, Lee JH, Lee MA, Lee PH, Joo IS et al (2005) Association of the metabolic syndrome with intracranial atherosclerotic stroke. Neurology 65(2):296–298CrossRefPubMed Bang OY, Kim JW, Lee JH, Lee MA, Lee PH, Joo IS et al (2005) Association of the metabolic syndrome with intracranial atherosclerotic stroke. Neurology 65(2):296–298CrossRefPubMed
13.
go back to reference Ovbiagele B, Saver JL, Lynn MJ, Chimowitz M, WASID Study Group (2006) Impact of metabolic syndrome on prognosis of symptomatic intracranial atherostenosis. Neurology 66(9):1344–1349CrossRefPubMed Ovbiagele B, Saver JL, Lynn MJ, Chimowitz M, WASID Study Group (2006) Impact of metabolic syndrome on prognosis of symptomatic intracranial atherostenosis. Neurology 66(9):1344–1349CrossRefPubMed
14.
go back to reference Hata J, Doi Y, Ninomiya T, Tanizaki Y, Yonemoto K, Fukuhara M et al (2010) The effect of metabolic syndrome defined by various criteria on the development of ischemic stroke subtypes in a general Japanese population. Atherosclerosis 210(1):249–255CrossRefPubMed Hata J, Doi Y, Ninomiya T, Tanizaki Y, Yonemoto K, Fukuhara M et al (2010) The effect of metabolic syndrome defined by various criteria on the development of ischemic stroke subtypes in a general Japanese population. Atherosclerosis 210(1):249–255CrossRefPubMed
15.
go back to reference Duvall WL, Vorchheimer DA (2004) Multi-bed vascular disease and atherothrombosis: scope of the problem. J Thromb Thrombolysis 17(1):51–61CrossRefPubMed Duvall WL, Vorchheimer DA (2004) Multi-bed vascular disease and atherothrombosis: scope of the problem. J Thromb Thrombolysis 17(1):51–61CrossRefPubMed
16.
go back to reference Novo S, Peritore A, Trovato RL, Guarneri FP, Di Lisi D, Muratori I et al (2013) Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up. Cardiovasc Diabetol 12:155PubMedCentralCrossRefPubMed Novo S, Peritore A, Trovato RL, Guarneri FP, Di Lisi D, Muratori I et al (2013) Preclinical atherosclerosis and metabolic syndrome increase cardio- and cerebrovascular events rate: a 20-year follow up. Cardiovasc Diabetol 12:155PubMedCentralCrossRefPubMed
17.
go back to reference Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24(1):35–41CrossRefPubMed Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24(1):35–41CrossRefPubMed
18.
go back to reference Teramoto T, Sasaki J, Ueshima H, Egusa G, Kinoshita M, Shimamoto K et al (2007) Diagnostic criteria for dyslipidemia. Executive summary of Japan Atherosclerosis Society (JAS) guideline for diagnosis and prevention of atherosclerotic cardiovascular diseases for Japanese. J Atheroscler Thromb 14(4):155–158CrossRefPubMed Teramoto T, Sasaki J, Ueshima H, Egusa G, Kinoshita M, Shimamoto K et al (2007) Diagnostic criteria for dyslipidemia. Executive summary of Japan Atherosclerosis Society (JAS) guideline for diagnosis and prevention of atherosclerotic cardiovascular diseases for Japanese. J Atheroscler Thromb 14(4):155–158CrossRefPubMed
19.
go back to reference Román GC (2002) Vascular dementia revisited: diagnosis, pathogenesis, treatment, andprevention. Med Clin North Am 86(3):477–499CrossRefPubMed Román GC (2002) Vascular dementia revisited: diagnosis, pathogenesis, treatment, andprevention. Med Clin North Am 86(3):477–499CrossRefPubMed
20.
go back to reference Yates KF, Sweat V, Yau PL, Turchiano MM, Convit A (2012) Impact of metabolic syndrome on cognition and brain: a selected review of the literature. Arterioscler Thromb Vasc Biol 32(9):2060–2067PubMedCentralCrossRefPubMed Yates KF, Sweat V, Yau PL, Turchiano MM, Convit A (2012) Impact of metabolic syndrome on cognition and brain: a selected review of the literature. Arterioscler Thromb Vasc Biol 32(9):2060–2067PubMedCentralCrossRefPubMed
21.
go back to reference Arenillas JF, Moro MA, Dávalos A (2007) The metabolic syndrome and stroke: potential treatment approaches. Stroke 38(7):2196–2203CrossRefPubMed Arenillas JF, Moro MA, Dávalos A (2007) The metabolic syndrome and stroke: potential treatment approaches. Stroke 38(7):2196–2203CrossRefPubMed
22.
go back to reference Farooqui AA, Farooqui T, Panza F, Frisardi V (2012) Metabolic syndrome as a risk factor for neurological disorders. Cell Mol Life Sci 69(5):741–762CrossRefPubMed Farooqui AA, Farooqui T, Panza F, Frisardi V (2012) Metabolic syndrome as a risk factor for neurological disorders. Cell Mol Life Sci 69(5):741–762CrossRefPubMed
23.
go back to reference Rodríguez-Flores M, García-García E, Cano-Nigenda CV, Cantú-Brito C (2014) Relationship of obesity and insulin resistance with the cerebrovascular reactivity: a case control study. Cardiovasc Diabetol 13:2PubMedCentralCrossRefPubMed Rodríguez-Flores M, García-García E, Cano-Nigenda CV, Cantú-Brito C (2014) Relationship of obesity and insulin resistance with the cerebrovascular reactivity: a case control study. Cardiovasc Diabetol 13:2PubMedCentralCrossRefPubMed
24.
go back to reference van Rooy MJ, Pretorius E (2015) Metabolic syndrome, platelet activation and the development of transient ischemic attack or thromboembolic stroke. Thromb Res 135(3):434–442CrossRefPubMed van Rooy MJ, Pretorius E (2015) Metabolic syndrome, platelet activation and the development of transient ischemic attack or thromboembolic stroke. Thromb Res 135(3):434–442CrossRefPubMed
25.
go back to reference Bokura H, Yamaguchi S, Iijima K, Nagai A, Oguro H (2008) Metabolic syndrome is associated with silent ischemic brain lesions. Stroke 39(5):1607–1609CrossRefPubMed Bokura H, Yamaguchi S, Iijima K, Nagai A, Oguro H (2008) Metabolic syndrome is associated with silent ischemic brain lesions. Stroke 39(5):1607–1609CrossRefPubMed
26.
go back to reference Park JH, Kwon HM (2008) Association between metabolic syndrome and previous ischemic lesions in patients with intracranial atherosclerotic stroke. Clin Neurol Neurosurg 110(3):215–221CrossRefPubMed Park JH, Kwon HM (2008) Association between metabolic syndrome and previous ischemic lesions in patients with intracranial atherosclerotic stroke. Clin Neurol Neurosurg 110(3):215–221CrossRefPubMed
27.
go back to reference Mak KH, Ma S, Heng D, Tan CE, Tai ES, Topol EJ et al (2007) Impact of sex, metabolic syndrome, and diabetes mellitus on cardiovascular events. Am J Cardiol 100(2):227–233CrossRefPubMed Mak KH, Ma S, Heng D, Tan CE, Tai ES, Topol EJ et al (2007) Impact of sex, metabolic syndrome, and diabetes mellitus on cardiovascular events. Am J Cardiol 100(2):227–233CrossRefPubMed
28.
go back to reference Takahashi K, Bokura H, Kobayashi S, Iijima K, Nagai A, Yamaguchi S (2007) Metabolic syndrome increases the risk of ischemic stroke in women. Intern Med 46(10):643–648CrossRefPubMed Takahashi K, Bokura H, Kobayashi S, Iijima K, Nagai A, Yamaguchi S (2007) Metabolic syndrome increases the risk of ischemic stroke in women. Intern Med 46(10):643–648CrossRefPubMed
29.
go back to reference Niwa Y, Ishikawa S, Gotoh T, Kayaba K, Nakamura Y, Kajii E (2010) Association between stroke and metabolic syndrome in a Japanese population: Jichi Medical School (JMS) Cohort Study. J Epidemiol 20(1):62–69PubMedCentralCrossRefPubMed Niwa Y, Ishikawa S, Gotoh T, Kayaba K, Nakamura Y, Kajii E (2010) Association between stroke and metabolic syndrome in a Japanese population: Jichi Medical School (JMS) Cohort Study. J Epidemiol 20(1):62–69PubMedCentralCrossRefPubMed
30.
go back to reference Okada K (2008) Which diagnostic criteria of metabolic syndrome can better predict the risk of ischemic heart disease and stroke in Japanese and Asian populations? Hypertens Res 31(12):2103–2104CrossRefPubMed Okada K (2008) Which diagnostic criteria of metabolic syndrome can better predict the risk of ischemic heart disease and stroke in Japanese and Asian populations? Hypertens Res 31(12):2103–2104CrossRefPubMed
31.
go back to reference Kurth T, Logroscino G (2008) The metabolic syndrome: more than the sum of its components? Stroke 39(4):1068–1069CrossRefPubMed Kurth T, Logroscino G (2008) The metabolic syndrome: more than the sum of its components? Stroke 39(4):1068–1069CrossRefPubMed
32.
go back to reference Jeremy RW (2011) Metabolic syndrome–is the whole really greater than the sum of the parts? Heart Lung Circ 20(4):211–213CrossRefPubMed Jeremy RW (2011) Metabolic syndrome–is the whole really greater than the sum of the parts? Heart Lung Circ 20(4):211–213CrossRefPubMed
33.
go back to reference Tanne D, Koren-Morag N, Graff E, Goldbourt U (2001) Blood lipids and first-ever ischemic stroke/transient ischemic attack in the Bezafibrate Infarction Prevention (BIP) Registry: high triglycerides constitute an independent risk factor. Circulation 104(24):2892–2897CrossRefPubMed Tanne D, Koren-Morag N, Graff E, Goldbourt U (2001) Blood lipids and first-ever ischemic stroke/transient ischemic attack in the Bezafibrate Infarction Prevention (BIP) Registry: high triglycerides constitute an independent risk factor. Circulation 104(24):2892–2897CrossRefPubMed
34.
go back to reference Sone H, Mizuno S, Fujii H, Yoshimura Y, Yamasaki Y, Ishibashi S et al (2005) Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in asian diabetic patients? Analysis from the Japan Diabetes Complications Study. Diabetes Care 28(6):1463–1471CrossRefPubMed Sone H, Mizuno S, Fujii H, Yoshimura Y, Yamasaki Y, Ishibashi S et al (2005) Is the diagnosis of metabolic syndrome useful for predicting cardiovascular disease in asian diabetic patients? Analysis from the Japan Diabetes Complications Study. Diabetes Care 28(6):1463–1471CrossRefPubMed
35.
go back to reference Milionis HJ, Kostapanos MS, Liberopoulos EN, Goudevenos J, Athyros VG, Mikhailidis DP et al (2007) Different definitions of the metabolic syndrome and risk of first-ever acute ischaemic non-embolic stroke in elderly subjects. Int J Clin Pract 61(4):545–551CrossRefPubMed Milionis HJ, Kostapanos MS, Liberopoulos EN, Goudevenos J, Athyros VG, Mikhailidis DP et al (2007) Different definitions of the metabolic syndrome and risk of first-ever acute ischaemic non-embolic stroke in elderly subjects. Int J Clin Pract 61(4):545–551CrossRefPubMed
Metadata
Title
Association between metabolic syndrome and multiple lesions of intracranial atherothrombotic stroke: a hospital-based study
Authors
Kazuhiko Kotani
Noriko Satoh-Asahara
Takuya Nakakuki
Hajime Yamakage
Akira Shimatsu
Tetsuya Tsukahara
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0272-6

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