title: The metabolic syndrome predicts incident stroke: a 14-year follow-up study in elderly people in Finland.
abstract: OBJECTIVE
  Limited information is available on the role of the metabolic syndrome (MetS) to predict stroke. We investigated the relationship of the MetS and its single components, defined by 6 different criteria, with stroke in a prospective population-based study.
  
  
  METHODS
  The MetS was defined according to the World Health Organization, the European Group for the Study of Insulin Resistance, the National Cholesterol Education Program (NCEP), the American College of Endocrinology, the International Diabetes Federation, and the American Heart Association (updated NCEP) criteria. We investigated the relationship of the MetS with stroke using Cox regression analyses in 991 Finnish subjects without diabetes, aged 65 to 74 years at baseline, and followed-up for 14 years.
  
  
  RESULTS
  The MetS defined by the World Health Organization, European Group for the Study of Insulin Resistance, NCEP, International Diabetes Federation, and updated NCEP criteria was significantly associated with incident stroke (fatal and nonfatal) when adjusted for confounding variables (HR, 1.52 to 1.72). After exclusion of subjects with myocardial infarction, these 5 definitions still predicted stroke (HR, 1.49 to 1.80). Of the single components of the MetS, the following predicted stroke in multivariable models when subjects with myocardial infarction were excluded: impaired glucose tolerance (2-hour glucose in an oral glucose tolerance test, 7.8 to 11.0 mmol/L) by the World Health Organization and American College of Endocrinology criteria (HR, 1.66); insulin resistance (HR, 1.60) by the European Group for the Study of Insulin Resistance criteria; and central obesity (HR, 1.52) by the NCEP criteria.
  
  
  CONCLUSIONS
  The MetS defined by the 6 criteria except for the American College of Endocrinology definition predicts stroke in elderly subjects. However, impaired glucose tolerance alone is as strong a predictor of stroke as is the MetS defined by the World Health Organization, NCEP and updated NCEP criteria.
authors.affiliation: Department of Medicine, Cardiology Unit, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Wang
authors.forename: Sanna
authors.initials: S
authors.lastname: Ruotsalainen
authors.forename: Leena
authors.initials: L
authors.lastname: Moilanen
authors.forename: Päivi
authors.initials: P
authors.lastname: Lepistö
authors.forename: Markku
authors.initials: M
authors.lastname: Laakso
authors.forename: Johanna
authors.initials: J
authors.lastname: Kuusisto
mesh_terms: D000368:Aged; D001786:Blood Glucose; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology*
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL