Association between stroke and metabolic syndrome in a Japanese population: Jichi Medical School (JMS) Cohort Study.
BACKGROUND
Metabolic syndrome increases the morbidity and mortality of cardiovascular diseases. However, few studies have examined the association between the incidence of stroke and metabolic syndrome, as defined by Japanese criteria. The aim of this study was to identify the association between stroke and metabolic syndrome, as defined by criteria used in Japan.


METHODS
A total of 2205 subjects (920 men and 1285 women) were examined between 1992 and 1995 as part of the Jichi Medical School Cohort Study. Metabolic syndrome was defined using the Japanese criteria. Medical records, computed tomography, and magnetic resonance imaging were used to diagnose stroke. The Cox proportional-hazards model was used to analyze the association between metabolic syndrome and incident stroke.


RESULTS
The prevalence of metabolic syndrome at baseline was 9.0% in men and 1.7% in women. There were 96 incident strokes during an 11.2-year follow-up period, 14 of which occurred in subjects with metabolic syndrome. Among subjects with metabolic syndrome, the age-adjusted hazard ratio (95% confidence interval) for stroke was 1.93 (0.94-3.96) in men and 6.85 (2.68-17.47) in women. After adjusting for age, smoking status, and alcohol drinking status, the hazard ratio was 1.89 (0.88-4.08) in men and 7.24 (2.82-18.58) in women. Age-adjusted hazard ratios associated with having 2 or more components of metabolic syndrome, with and without central obesity, were 2.93 (1.21-7.08) and 3.20 (1.23-8.31) in men and 1.75 (0.69-4.44) and 8.64 (2.82-28.03) in women, respectively.


CONCLUSIONS
The presence of metabolic syndrome, as defined by Japanese criteria, increases the risk of stroke; this effect was highly significant among women.
Niwa
Yasunori
Y
Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan. yasu-niw@jichi.ac.jp
Ishikawa
Shizukiyo
S
Gotoh
Tadao
T
Kayaba
Kazunori
K
Nakamura
Yosikazu
Y
Kajii
Eiji
E
D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D056128:Obesity, Abdominal; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D015898:Tomography Scanners, X-Ray Computed