title: Atherosclerotic vascular disease rather than metabolic syndrome predicts ischemic stroke in diabetic patients.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effect of metabolic syndrome on ischemic stroke in Chinese subjects with type 2 diabetes.
  
  
  METHODS
  Anthropometric parameters (waist circumference and body mass index), blood pressure, and plasma biochemical (lipid and glycemic profiles) were collected. Subjects with type 2 diabetes were categorized by the criteria of the updated Adult Treatment Panel III (ATP III) with the modified definitions of obesity in Asians. Transcranial Doppler was performed to define middle cerebral artery stenosis.
  
  
  RESULTS
  Of 2,197 patients (age 55.4 +/- 11.3 years; male 40.8%; median follow-up period 8.7 years, interquartile range 7.8-9.5 years) without symptoms of cerebrovascular disease, evidence of middle cerebral artery stenosis was identified in 272 subjects (12.4%). According to NCEP ATP III criteria, 1,324 (60.3%) patients had MetS at baseline. Ischemic stroke occurred in 184 (8.4%, 184/2197) patients during follow-up. Patients with incident stroke had a higher prevalence of MetS compared with those without stroke (p = 0.004), and the number of components of MetS was also significantly increased in patients with stroke (p = 0.001). Cox regression demonstrated that MetS was not associated with incident stroke.
  
  
  CONCLUSIONS
  In Chinese type 2 diabetic patients, metabolic syndrome does affect stroke occurrence with a higher stroke incidence among those with metabolic syndrome, but stroke occurrence seems to be better explained by other vascular risk factors than by metabolic syndrome.
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China.
authors.forename: Xiang Yan
authors.initials: XY
authors.lastname: Chen
authors.forename: G Neil
authors.initials: GN
authors.lastname: Thomas
authors.forename: Yang Kun
authors.initials: YK
authors.lastname: Chen
authors.forename: Juliana C N
authors.initials: JC
authors.lastname: Chan
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000150:complications* / Q000208:ethnology; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000208:ethnology; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology; D017585:Ultrasonography, Doppler, Transcranial