代谢综合征在缺血性卒中患者心脑血管事件发生中的作用

Objective To explore the association between metabolic syndrome (MS) and risk of cardiovascular disease events (CVD) in patients with ischemic stroke. Method A total of 1087 patients with ischemic stroke were enrolled from 5 community-based medical centres and underwent baseline evaluation on risk factors of stroke during the period of Jar. 2003 to Dec. 2006. After baseline survey, all patients were followed up until Dec 31, 2008 and new CVD events were recorded. MS was defined using CDS criteria. Proportional hazard models were used to assess the HRus and 95% CI of CVD events associated with MS and other components. Results The prevalence of MS was 40. 4% at baseline. During an average follow-up of 3.5 years, 178 patients developed new CVD events. After adjusted for age, gender, smoking,drinking, marriage status, education level, hospitalization, recurrence of stroke, stroke duration,depression, cognition impairment and ADL, MS remains the independent predictor for the risk of CVD events. Compared with patients with non-MS, the risk of CVD events increased by 44% (HR:1.44, 95%CI:1.06-1.95 ). The risk of CVD also increased with the number of MS components. Compared with patients with 1 or less than 1 components of MS, the risk of CVD events increased by 30% (HR:1. 30,95%CI:0.83-2.04) in those with 2 components and by 69% ( HR: 1.69,95% CI: 1.11-2.56) in those with 3or more components of MS. Hypertension and hyperglycemia and impaired fasting glucose also served as independent risk factors for CVD event ( all P ＜ 0. 001 ) . Conclusions MS was independently associated with increased risk of CVD events in patients with ischemic stroke. There was a dose-response relationship between the numbers of MS components and the risk of CVD event.