| Summary: | 博士 === 國防醫學院 === 生命科學研究所 === 102 === The main purpose of the study is to evaluate relationships of metabolic syndrome components and stroke (including ischemic stroke and hemorrhagic stroke) risk in a cohort of Chinese subjects. The following study projects were conducted to evaluate the study aim: 1. To understand the prevalence of the clustering patterns of metabolic syndrome compounds. 2. To examine risk of stroke subtypes in relation to the full definition of metabolic syndrome and its components. 3. To evaluate the impact of number of metabolic syndrome components on incident strokes risk. 4. To evulate the joint effect of the metabolic syndrome component and the full definition of metabolic syndrome on the risk of incident stroke subtype.
Our analysis showed that hypertriglyceridemia (88.2%), central obesity (78.2%) and hypertension (76.3%) were main traits to form metabolic syndrome in this ethnic Chinese. We determined that the presence of hypertension per se (ischemic stroke: HR=2.22, 95% CI=1.52-3.23; hemorrhagic stroke: HR=4.19, 95% CI=1.92-9.15) or MetS defined by the presence of hypertension (ischemic stroke: HR=2.96, 95% CI=1.94-4.50; hemorrhagic stroke: HR=2.93, 95% CI=1.25-6.90) significantly predicted the incidences of ischemic and hemorrhagic strokes. Likewise, the several coronary heart disease studies documented that a full definition of metabolic syndrome did not perform better than its individual components in prediction of coronary artery disease. In addition, as the number of metabolic syndrome components increased, the risk of ischemic stroke increased (p for trend<0.001). This implies a cumulative effect of metabolic syndrome components in elevating the risk of ischemic stroke.
In conclusion, the metabolic syndrome comprises heterogeneous clusters with respect to the risk of stroke subtypes. More intensive efforts should be directed toward prevention and management of the individual components of metabolic syndrome, particularly hypertension, to reduce the burden of the subtype of stroke.
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