Comparison of Definitions of Metabolic Syndrome in Relation to the Risk of Developing Stroke and Coronary Heart Disease in Finnish and Swedish Cohorts

Qiao, Qing; Laatikainen, Tiina; Zethelius, Björn; Stegmayr, Birgitta; Eliasson, Mats; Jousilahti, Pekka; Tuomilehto, Jaakko

doi:10.1161/strokeaha.108.518878

Cited by 39 publications

(31 citation statements)

References 29 publications

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“…In the general population MetS was accompanied by a four-to five-fold increase in diabetes mellitus (37) and a 1.5-to 2-fold increase in cardiovascular disease (38,39). A similar pattern has been observed in the present analysis, since the prevalence ratio for diabetes was 4.65, for cardiovascular diseases 1.91, and for cerebrovascular disease 1.77 when comparing the MetS group with the noMetS group.…”

Section: Discussionsupporting

confidence: 88%

Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis

Verhelst

Mattsson

Luger

et al. 2011

European Journal of Endocrinology

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Objective: An increased risk of cardiovascular morbidity and mortality in adult GH deficiency (GHD) may be related to hypopituitarism but also to the presence of the metabolic syndrome (MetS). Our objective was to investigate the characteristics and prevalence of MetS as well as its comorbidities in adult GHD. Design: In KIMS (Pfizer International Metabolic Database) 2479 patients with severe adult-onset GHD, naïve to GH replacement, with complete information on all MetS components were found. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP) and the International Diabetes Foundation (IDF). Methods: The prevalence of MetS was calculated and compared with previously published data from the normal population. Associations were assessed between background variables, baseline variables, comorbidities, and MetS. Results: MetS was present in 43.1% (NCEP) and in 49.1% (IDF) of patients, clearly higher than data from the normal population (20-30%). MetS prevalence was related to age, GHD duration, and body mass index (BMI), but not to GHD severity, extent of hypopituitarism, or etiology of pituitary disease. Adjusted for age, gender, and BMI, patients with MetS had a higher prevalence ratio for diabetes mellitus: 4.65 (95% confidence interval (CI): 3.29-6.58), for cardiovascular morbidity: 1.91 (95% CI: 1.33-2.75), and for cerebrovascular morbidity: 1.77 (95% CI: 1.09-2.87) than patients without MetS. Conclusions: MetS is highly prevalent in GHD and is associated with a higher prevalence ratio for comorbidities. The presence of MetS in GHD may therefore contribute to the increased risk of cardiovascular morbidity and mortality found in these patients.

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Section: Discussionsupporting

confidence: 88%

Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis

Verhelst

Mattsson

Luger

et al. 2011

European Journal of Endocrinology

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“…More than 15 cohort studies have reported statistically significant adjusted RRs for ischemic stroke that range between 1.5 and 5.1, with most between 2.0 and 2.5. 162,175,[177][178][179][180][181][182][183] A point estimate of 2.27 (95% CI, 1.80-2.85) was suggested by a meta-analysis that examined risk for any stroke (ie, ischemic or hemorrhagic). A few studies have reported no association.…”

Section: Metabolic Syndromementioning

confidence: 99%

“…110,167 Among components of the syndrome, hypertension and hyperglycemia may have the largest effect on ischemic stroke risk. 162,182 As is the case for CVD, classification of patients according to the metabolic syndrome does not significantly improve stroke risk estimation beyond what can be accomplished with traditional risk factors. 166,175,183,184 Information on silent brain infarction is from case-control studies that have reported ORs of 2.1 to 2.4 for any infarction 185,186 and 6.5 for lacunar infarction.…”

Section: Metabolic Syndromementioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

3,937

1,326

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The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

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“…157,158 Furthermore, the metabolic syndrome has not been associated with risk of developing cardiovascular disease in the elderly (70 to 82 years of age), limiting its generalizability in a typical stroke population. 161 The association between the metabolic syndrome and risk for first ischemic stroke has been examined in several recent studies, 158,[162][163][164][165][166][167][168][169][170] all but one of which have confirmed the association. 168 The predictive value of the metabolic syndrome relative to its individual components or simpler composite risk scores has not been adequately examined.…”

Section: H Metabolic Syndromementioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack

Furie¹,

Kasner²,

Adams³

et al. 2011

Stroke

1,411

591

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Abstract-The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches for atherosclerotic disease, antithrombotic treatments for cardioembolism, and the use of antiplatelet agents for noncardioembolic stroke. Further recommendations are provided for the prevention of recurrent stroke in a variety of other specific circumstances, including arterial dissections; patent foramen ovale; hyperhomocysteinemia; hypercoagulable states; sickle cell disease; cerebral venous sinus thrombosis; stroke among women, particularly with regard to pregnancy and the use of postmenopausal hormones; the use of anticoagulation after cerebral hemorrhage; and special approaches to the implementation of guidelines and their use in high-risk populations. (Stroke. 2011;42:227-276.)

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Comparison of Definitions of Metabolic Syndrome in Relation to the Risk of Developing Stroke and Coronary Heart Disease in Finnish and Swedish Cohorts

Cited by 39 publications

References 29 publications

Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis

Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack

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