The effect of metabolic syndrome defined by various criteria on the development of ischemic stroke subtypes in a general Japanese population.
OBJECTIVE
We evaluated the impact of metabolic syndrome (MetS) defined by various criteria on the occurrence of ischemic stroke subtypes in a general Japanese population.


METHODS
A total of 2452 residents of a Japanese community, Hisayama, aged 40 years or older, were followed up for 14 years. To define MetS, we used the original Japanese criteria, the modified Japanese criteria, the International Diabetes Federation (IDF) criteria, the original National Cholesterol Education Program's Adult Treatment Panel III (NCEP) criteria, and the modified NCEP criteria. We substituted a waist circumference of > or = 90 cm in men and > or = 80 cm in women for the values of > or = 85 cm and > or = 90 cm, respectively, in the modified Japanese criteria and for > 102 cm and > 88cm, respectively, in the modified NCEP criteria.


RESULTS
Only MetS defined by the modified Japanese criteria showed a significant association with the development of lacunar infarction, and its hazard ratios (HRs) for the development of atherothrombotic and cardioembolic infarction were significant and greater than those of MetS defined by the other criteria: adjusted HRs for lacunar, atherothrombotic and cardioembolic infarction were 1.94 (95% confidence interval (CI), 1.13-3.32; P=0.02), 2.55 (95% CI, 1.25-5.18; P=0.01) and 3.94 (95% CI, 1.89-8.22, P<0.001), respectively, after adjustment for confounding factors.


CONCLUSIONS
Our findings suggest that MetS defined by the Japanese criteria with the modification of a waist circumference of > or = 90 cm in men and > or = 80 cm in women is a better predictor of each ischemic stroke subtype in the Japanese population.
Hata
Jun
J
Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City 812-8582, Japan. junhata@envmed.med.kyushu-u.ac.jp
Doi
Yasufumi
Y
Ninomiya
Toshiharu
T
Tanizaki
Yumihiro
Y
Yonemoto
Koji
K
Fukuhara
Masayo
M
Kubo
Michiaki
M
Kitazono
Takanari
T
Iida
Mitsuo
M
Kiyohara
Yutaka
Y
D000328:Adult; D002545:Brain Ischemia / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology*; D055105:Waist Circumference