İncidence of metabolic syndrome in ischemic cerebrovascular disease and the role of carotid intima-media thickness

Abstract

Objective: Metabolic syndrome (MtS) is a clinical entity, whose incidence is increasing because of sedentary lifestyle and alimentary changes. Research studies on cardiovascular diseases show that MtS has influence on atherosclerosis, which led to new investigations regarding the place of MtS in ischemic cerebrovascular disease. The alterations in carotid intima-media thickness (CIMT) can be considered as an early sign of atherosclerosis. The aim of our study was to detect the incidence of MtS in ischemic cerebrovascular disease and to interrogate the relation of CIMT with MtS and its components. Met hods: 194 patients with ischemic stroke admitted to Baki{dotless}rköy Mental Health Hospital, 3rd Neurology Clinic between April 2007 and April 2009 were included in the study. Routine blood tests, including blood glucose and lipid profiles, were performed; blood pressure and waist circumference were measured and recorded for all subjects. The patients were diagnosed with MtS using the NCEP diagnostic criteria. Carotid Doppler Duplex ultrasound was performed to 133 patients in order to determine the CIMT. 99 patients were divided into two groups according to presence/absence of MtS. CIMT, the Oxfordshire Community of Stroke Project (OCSP) and the Trial of Org 10172 in Acute Stroke Treatment (TOAST) were examined in the two groups. Re sults: Out of 194 patients with stroke in our study, 126 (60.3% women and 39.7% men) had MtS. MtS was detected in 22.2% of patients younger than 50 years of age, in 23% of those between 50-60 years, in 32.5% between 60-70 years and in 22.2% of subjects older than 70 years of age. The distribution of age and gender did not differ between stroke and MtS patients. Also the TOAST and OCSP classifications were similar in the two groups. CIMT was greater in 117 patients. There was no relationship of CIMT with blood glucose level, waist circumference and HDL. However, there were statistically significant relations of CIMT with triglyceride (TG) levels and hypertension (HT) (p=0.004, p=0.007). In the study, there was no difference between the MtS group and the non-MtS group in terms of gender, CIMT and TOAST. However, in the MtS group, posterior circulation infarcts were less frequently observed (p=0.04). C onc lu si on: The incidence of metabolic syndrome was higher among stroke patients compared to the general population. In our study, we found that CIMT significantly correlated with TG and HT, but not with MtS. As CIMT is an early sign of atherosclerosis, especially in hypertensive patients and in patients who have high TG levels, it can also be a predictor of future stroke. © Archives of Neuropsychiatry, published by Galenos Publishing.