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Metabolic syndrome adds to diabetes stroke risk.

Patients with both type 2 diabetes and metabolic syndrome have strokes an average of 3.5 years earlier than do those who have type 2 diabetes alone, according to a study.

There were no significant differences between diabetes patients with and without metabolic syndrome in the type of stroke, with lacunar stroke predominating in both groups, wrote Imtiaz M. Shah and colleagues from Ayr (Scotland) Hospital (Diabetes Res. Clin. Prac. 2008;79:el-4).

The retrospective study involved 151 patients with metabolic syndrome and type 2 diabetes, and a control group of 92 patients with diabetes alone. All patients had experienced a stroke between September 1996 and August 2004. Patients were considered to have metabolic syndrome if they had two or more of the following additional risk factors: obesity, low HDL cholesterol, elevated triglycerides, or hypertension.

Patients with metabolic syndrome experienced their stroke at an average of 71.7 years of age, compared with 75.2 years among the control group, a statistically significant difference. Other than the defining characteristics of metabolic syndrome, the only other significant difference between the groups was in the proportion taking statins, which was 40% among patients with metabolic syndrome and 24% among the control group.

Lacunar stroke, an indication of small-vessel disease, was responsible for 44% of strokes in both control patients and 44% of strokes in patients with metabolic syndrome. Transient ischemic attacks accounted for 39% of the strokes in control patients and 38% of the patients with metabolic syndrome; cortical strokes accounted for 15% and 13% of the strokes, respectively; and intracerebral hemorrhage accounted for the remaining 2% and 5% of the strokes. A multivariate analysis revealed no statistically significant differences between the groups in stroke subtypes.

The results emphasize the importance of aggressive management of patients with both metabolic syndrome and type 2 diabetes because of their high vascular risk state, the investigators wrote. They also noted that lacunar stroke has been associated with endothelial dysfunction, and that ACE inhibition, angiotensin receptor blockade treatment, and statins have all been shown to reverse endothelial dysfunction.

The investigators stated that they had no conflicts of interest.
Metabolic Syndrome Associated With Earlier Occurance of Stroke in
Diabetic Patients

Age (years)
Type 2 diabetes plus metabolic syndrome ( n = 151) 71.7
Type 2 diabetes alone ( n = 92) 75.2

Source: Diabetes Research and Clinical Practice

Note: Table made from bar graph.


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Title Annotation:Clinical Rounds
Author:Finn, Robert
Publication:OB GYN News
Date:Mar 15, 2008
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