Metabolic syndrome and its components as predictors of ischemic stroke in type 2 diabetic patients

Background and Purpose - The available data regarding the association between metabolic syndrome (MS) or MS components and ischemic stroke in type 2 diabetics are limited and inconsistent. This study aimed to investigate these associations. Methods - Five hundred ninety-nine consecutive type 2 diabetic patients (mean age 60.4 +/- 9.6 years, 54% men) were followed-up for 10.1 years (median period). Baseline clinical and laboratory characteristics and the occurrence of a first-ever ischemic stroke during follow-up were recorded. Results - Seventy-eight patients developed a first-ever ischemic stroke. According to Cox proportional hazard model, waist circumference (hazard ratio, HR: 1.006, 95% CI: 1.002 to 1.010, P = 0.003) and age (HR: 1.061, 95% CI: 1.002 to 1.125, P = 0.04) were significant predictors. After incorporating various combinations of MS components in multivariate models, only age and waist circumference remained significant. Conclusions - MS per se at baseline or combinations of its components do not predict the development of ischemic stroke in type 2 diabetic patients. Waist circumference represents an independent prognostic factor and could be used as a clinical tool for stroke prevention in this population.