Abstract
PurposeThe metabolic syndrome (MetS) is a major risk factor for cardiovascular diseases. We investigated potential associations between MetS and asymptomatic intracranial arterial stenosis (ICAS) in a general population.MethodsThe community-based “Asymptomatic Polyvascular Abnormalities in Community Study” examined asymptomatic polyvascular abnormalities in a Chinese population aged 40+ years without history of stroke and coronary heart disease. MetS was defined by the International Diabetes Federation criteria. Asymptomatic ICAS was diagnosed by transcranial color-coded Doppler sonography.ResultsOut of 5393 study participants, asymptomatic ICAS was detected in 713 (13.2%) participants, and MetS in 1323 (24.5%) individuals. Prevalence of asymptomatic ICAS increased significantly from 7.5% to 24.2% with increasing number of MetS components. After adjusting for age, gender, physical activity, body mass index, low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, MetS was significantly associated with asymptomatic ICAS (OR: 1.50; 95%CI: 1.23,1.83). Compared with the subgroup without MetS, the ORs for asymptomatic ICAS increased (P<0.0001) for each of 5 components of MetS from 1.71 (95%CI: 1.27,2.30), to 2.20 (95%CI: 1.63,2.98), 2.79 (95CI: 2.01,3.88), 3.08 (95%CI: 2.11,4.51) and 4.27 (95%CI: 2.22,8.20).ConclusionsIn multivariate analysis, MetS was an independent and additional factor associated with asymptomatic ICAS. Study participants with 5 MetS components had a 4 times higher risk of asymptomatic ICAS than participants with no MetS component.
Highlights
Intracranial arterial stenosis (ICAS) has been recognized as a serious cause of stroke, which is one of the worldwide leading causes of morbidity and mortality [1,2,3]
In multivariate analysis, metabolic syndrome (MetS) was an independent and additional factor associated with asymptomatic ICAS
Previous studies demonstrated that the traditional vascular disease risk factors, including arterial hypertension, diabetes mellitus and hyperlipidemia were independently associated with ICAS in general and symptomatic populations [4,5,6,7,8,9,10]
Summary
Intracranial arterial stenosis (ICAS) has been recognized as a serious cause of stroke, which is one of the worldwide leading causes of morbidity and mortality [1,2,3]. The metabolic syndrome (MetS) is characterized by a cluster of risk factors, i.e., visceral obesity, dyslipidemia, hyperglycemia, and arterial hypertension [11]. These risk factors which are linked to insulin resistance and an increased risk of cardiovascular diseases have become major public-health challenges worldwide [12,13,14,15,16,17,18]. Previous hospital-based studies revealed that MetS is associated with an increased risk of symptomatic ICAS in patients with stroke [19,20,21]. We conducted this study to investigate an association between MetS and asymptomatic ICAS in a community-based study population in which as compared to a hospital-based study population, the risk of a confounding effect by a bias due to the referral of patients may be less pronounced
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