Association Between Stroke and Metabolic Syndrome in a Japanese Population: Jichi Medical School (JMS) Cohort Study

Yasunori Niwa,Kazunori Kayaba,Yosikazu Nakamura,Shizukiyo Ishikawa,Tadao Gotoh,Eiji Kajii

doi:10.2188/jea.je20081041

Abstract

BackgroundMetabolic syndrome increases the morbidity and mortality of cardiovascular diseases. However, few studies have examined the association between the incidence of stroke and metabolic syndrome, as defined by Japanese criteria. The aim of this study was to identify the association between stroke and metabolic syndrome, as defined by criteria used in Japan.MethodsA total of 2205 subjects (920 men and 1285 women) were examined between 1992 and 1995 as part of the Jichi Medical School Cohort Study. Metabolic syndrome was defined using the Japanese criteria. Medical records, computed tomography, and magnetic resonance imaging were used to diagnose stroke. The Cox proportional-hazards model was used to analyze the association between metabolic syndrome and incident stroke.ResultsThe prevalence of metabolic syndrome at baseline was 9.0% in men and 1.7% in women. There were 96 incident strokes during an 11.2-year follow-up period, 14 of which occurred in subjects with metabolic syndrome. Among subjects with metabolic syndrome, the age-adjusted hazard ratio (95% confidence interval) for stroke was 1.93 (0.94–3.96) in men and 6.85 (2.68–17.47) in women. After adjusting for age, smoking status, and alcohol drinking status, the hazard ratio was 1.89 (0.88–4.08) in men and 7.24 (2.82–18.58) in women. Age-adjusted hazard ratios associated with having 2 or more components of metabolic syndrome, with and without central obesity, were 2.93 (1.21–7.08) and 3.20 (1.23–8.31) in men and 1.75 (0.69–4.44) and 8.64 (2.82–28.03) in women, respectively.ConclusionsThe presence of metabolic syndrome, as defined by Japanese criteria, increases the risk of stroke; this effect was highly significant among women.

Highlights

Metabolic syndrome is defined as a cluster of risk factors—central obesity, hypertension, hyperlipidemia, and impaired glucose tolerance—that increases cardiovascular disease morbidity and mortality.[1,2] The third revision of the US Adult Treatment Panel guidelines for cholesterol testing and management was published by the National Cholesterol Education Program in 2001.3 In 2005, the Examination Committee of Criteria for Metabolic Syndrome in Japan proposed a new set of criteria for the diagnosis of metabolic syndrome.[4]
We investigated the associations between stroke and metabolic syndrome, as defined by Japanese criteria, in the general Japanese population
Our findings suggest that metabolic syndrome was associated with an increased incidence of stroke; this effect was statistically significant in women

Summary

Introduction

Metabolic syndrome is defined as a cluster of risk factors—central obesity, hypertension, hyperlipidemia, and impaired glucose tolerance—that increases cardiovascular disease morbidity and mortality.[1,2] The third revision of the US Adult Treatment Panel guidelines for cholesterol testing and management was published by the National Cholesterol Education Program in 2001.3 In 2005, the Examination Committee of Criteria for Metabolic Syndrome in Japan proposed a new set of criteria for the diagnosis of metabolic syndrome.[4]. Few studies have examined the association between the incidence of stroke and metabolic syndrome, as defined by Japanese criteria. The aim of this study was to identify the association between stroke and metabolic syndrome, as defined by criteria used in Japan. The Cox proportional-hazards model was used to analyze the association between metabolic syndrome and incident stroke. Among subjects with metabolic syndrome, the age-adjusted hazard ratio (95% confidence interval) for stroke was 1.93 (0.94–3.96) in men and 6.85 (2.68–17.47) in women. Age-adjusted hazard ratios associated with having 2 or more components of metabolic syndrome, with and without central obesity, were 2.93 (1.21–7.08) and 3.20 (1.23–8.31) in men and 1.75 (0.69–4.44) and 8.64 (2.82–28.03) in women, respectively. Conclusions: The presence of metabolic syndrome, as defined by Japanese criteria, increases the risk of stroke; this effect was highly significant among women

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