Metabolic syndrome and ischemic stroke risk - Northern Manhattan Study
Metabolic syndrome and ischemic stroke risk - Northern Manhattan Study
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DOI：
10.1161/strokeaha.107.496588
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发表时间：
2008-01-01
期刊：
影响因子：
8.3
通讯作者：
Paik, Myunghee C.
中科院分区：
文献类型：
--
作者：
Boden-Albala, Bernadette;Sacco, Ralph L.;Paik, Myunghee C.
背景和目的--在美国，超过4700万人符合代谢综合征的标准。多种族人群中代谢综合征和中风风险之间的关系尚未得到很好的描述。方法：作为曼哈顿北部研究的一部分，对3298名无中风社区居民进行了前瞻性随访，平均随访时间为6.4年。代谢综合征的定义是根据国家胆固醇教育计划成人治疗小组III制定的指南。使用COX比例风险模型计算缺血性中风和血管事件(缺血性中风、心肌梗死或血管死亡)的危险比(HR)和95%的CI。结果：超过44%的队列患者患有代谢综合征(女性为48%，男性为38%，P<；0.0001)，拉美裔(50%)比白人(39%)或黑人(37%)更常见。调整社会人口学和危险因素后，代谢综合征与卒中风险(HR=1.5；95%CI，1.1~2.2)和血管事件(HR=1.6；95%CI，1.3~2.0)增加相关。与黑人和白人相比，代谢综合征对中风风险的影响在女性中(HR=2.0；95%CI，1.3至3.1)大于男性(HR=1.1；95%CI，0.6至1.9)，在拉美裔(HR=2.0；95%CI，1.2至3.4)中。病因分数估计表明，消除代谢综合征将导致整体卒中减少19%，女性卒中减少30%，西班牙裔卒中减少35%。结论：代谢综合征是缺血性卒中的重要危险因素，其影响因性别和种族/民族而异。
Background and Purpose-More than 47 million individuals in the United States meet the criteria for the metabolicsyndrome. The relation between the metabolic syndrome and stroke risk in multiethnic populations has not been well characterized.Methods-As part of the Northern Manhattan Study, 3298 stroke-free community residents were prospectively followed up for a mean of 6.4 years. The metabolic syndrome was defined according to guidelines established by the National Cholesterol Education Program Adult Treatment Panel III. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and 95% CIs for ischemic stroke and vascular events (ischemic stroke, myocardial infarction, or vascular death). The etiologic fraction estimates the proportion of events attributable to the metabolic syndrome.Results-More than 44% of the cohort had the metabolic syndrome (48% of women vs 38% of men, P < 0.0001), which was more prevalent among Hispanics (50%) than whites (39%) or blacks (37%). The metabolic syndrome was associated with increased risk of stroke (HR=1.5; 95% CI, 1.1 to 2.2) and vascular events (HR=1.6; 95% CI, 1.3 to 2.0) after adjustment for sociodemographic and risk factors. The effect of the metabolic syndrome on stroke risk was greater among women (HR=2.0; 95% CI, 1.3 to 3.1) than men (HR=1.1; 95% CI, 0.6 to 1.9) and among Hispanics (HR=2.0; 95% CI, 1.2 to 3.4) compared with blacks and whites. The etiologic fraction estimates suggest that elimination of the metabolic syndrome would result in a 19% reduction in overall stroke, a 30% reduction of stroke in women; and a 35% reduction of stroke among Hispanics.Conclusions-The metabolic syndrome is an important risk factor for ischemic stroke, with differential effects by sex and race/ethnicity.