Metabolic syndrome and three of its components as risk factors for recurrent ischaemic stroke presenting as large-vessel infarction
Metabolic syndrome and three of its components as risk factors for recurrent ischaemic stroke presenting as large-vessel infarction
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DOI：
10.1111/j.1468-1331.2008.02181.x
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发表时间：
2008-08-01
影响因子：
5.1
通讯作者：
Yip, H. -K.
中科院分区：
文献类型：
--
作者：
Liou, C. -W.;Tan, T. -Y.;Yip, H. -K.
背景和目的：虽然已经建立了减少复发性缺血性卒中（RIS）的明确方案，但很少有研究比较RIS和首次卒中（FES）之间的卒中亚型分布和危险因素。方法：这项为期一年的以医院为基础的研究纳入了587例FES和475例RIS患者。根据改良的吐司卒中亚型分类系统将患者分为四种卒中亚型。比较两个主要卒中组和相应的四种亚型之间的危险因素概况，以区分RIS的重要危险因素。结果如下：多因素回归分析确定高血压（OR，1.87; 95%CI，1.34-2.62）、糖尿病（DM）（OR，1.57; 95%CI，1.22-2.02）、低高密度脂蛋白（LHDL）（OR，1.43; 95%CI，1.08-1.88）和年龄是RIS的重要危险因素。前三个RIS因素的重要性在其大血管亚型中得到进一步认识。此外，代谢综合征在复发性卒中组中明显更常见（P = 0.01），包括其大血管亚型（P = 0.04）。比值比从1.49逐渐增加到2.02，与复发性大血管缺血性卒中代谢综合征诊断成分数量增加一致。结论：代谢综合征可能在RIS的发展中起着至关重要的作用，包括现代台湾的大血管梗死。
Background and purpose: Although a clear protocol for reduction of recurrent ischaemic stroke (RIS) has been established, few studies have compared the stroke subtype distribution and risk factors between RIS and first-ever stroke (FES). Methods: This one-year hospital-based study enrolled 587 FES and 475 RIS patients. Patients were categorized into four stroke subtypes according to a modified TOAST stroke subtype classification system. Risk factor profiles were compared between the two major stroke groups and between the corresponding four subtypes to discriminate the significant risk factors for RIS. Results: A multivariate regression analysis identified hypertension (OR, 1.87; 95% CI, 1.34-2.62), diabetes mellitus (DM) (OR, 1.57; 95% CI, 1.22-2.02), low high-density lipoprotein (LHDL) (OR, 1.43; 95% CI, 1.08-1.88) and older age as significant RIS risk factors. The significance of the former three RIS factors was further recognized in its large-vessel subtype. Moreover, metabolic syndrome was significantly more common in the recurrent stroke group (P = 0.01), including its large-vessel subtype (P = 0.04). Progressively increasing odds ratios from 1.49 to 2.02, in accordance with increased number of diagnostic components of metabolic syndrome for recurrent large-vessel ischaemic stroke, were noted. Conclusions: Metabolic syndrome likely plays a crucial role in the development of RIS, including large-vessel infarction in modern-day Taiwan.