title: Metabolic Syndrome, Its Components, and Diabetes on 5-Year Risk of Recurrent Stroke among Mild-to-Moderate Ischemic Stroke Survivors: A Multiclinic Registry Study.
abstract: OBJECTIVE
  The pieces of evidence regarding whether metabolic syndrome (MetS) is a better predictor than its individual components, especially diabetes, for recurrent stroke are limited. This study aimed to examine these associations.
  
  
  METHODS
  A total of 1087 ischemic stroke patients were recruited consecutively from 2003 to 2004. They were followed up until the end of 2008. Baseline clinical and laboratory characteristics and new stroke event during follow-up were recorded. MetS was defined by the definition issued by the Chinese Medical Association/Chinese Diabetes Society.
  
  
  RESULTS
  One hundred forty-three new stroke cases were recorded. After adjusting for baseline age, gender, education, marriage status, subtype stroke, length of index stroke to baseline assessment, history of cardiac diseases, smoking status, drinking status, clinics, aspirin treatment, and fibrinogen by Cox regression models, the risk of recurrent stroke was 43% higher in MetS patients than in non-MetS patients (hazard ratio [HR] = 1.43, 95% confidence interval [CI]: 1.01-2.01). The strength of this association is weaker than MetS individual components such as elevated glycemia (adjusted HR = 1.78, 95% CI: 1.26-2.52), elevated blood pressure (adjusted HR = 1.91, 95% CI: 1.11-3.30), or low high-density lipoprotein cholesterol (adjusted HR = 1.57, 95% CI: 1.08-2.51). Compared with the group with neither MetS nor diabetes, the adjusted risk of recurrent stroke was highest in the group with diabetes (HR = 2.77, 95% CI: 1.66-4.63), followed by those with both MetS and diabetes (HR = 1.91, 95% CI: 1.25-2.94). The risk of recurrent stroke in patients with MetS in the absence of diabetes was similar to those with neither.
  
  
  CONCLUSIONS
  MetS is not superior to its individual components in predicting future recurrent stroke in patients who experience mild-to-moderate ischemic stroke.
authors.affiliation: Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Fang
authors.affiliation: Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Hongjun
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinqing
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China; Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Qin
authors.affiliation: Department of Neurological Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address: jixunming@vip.163.com.
authors.forename: Xunming
authors.initials: X
authors.lastname: Ji
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications; D002681:China; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis
keywords: Metabolic syndrome; diabetes; follow-up study; prognosis; recurrent stroke