Metabolic Risk Factors for Stroke and Transient Ischemic Attacks in Middle-Aged Men

Abstract

Background and Purpose-The impact of lipometabolic and glucometabolic disturbances on stroke incidence remains to be characterized in detail. We investigated relations of a comprehensive panel of baseline lipometabolic and glucometabolic variables to incident fatal and nonfatal stroke or transient ischemic attack (TIA), and stroke subtypes. Methods-A community-based prospective study of 2313 middle-aged men invited to a health survey at age 50. Results-During a follow-up of up to 32 years, 421 developed stroke or TIA. In Cox proportional hazards analyses adjusting for treatment with cardiovascular drugs at baseline, 1-standard deviation increases in body mass index, systolic and diastolic blood pressures, serum proinsulin, and lipoprotein(a) were associated with 11 to 35% increased risk for subsequent stroke/TIA. Electrocardiographic left ventricular hypertrophy and smoking were also associated with a higher risk for stroke/TIA. Essentially the same variables were related to brain infarction/TIA. Higher proportions of palmitic (16:0), palmitoleic (16:1), and oleic acid (18:1) in cholesterol esters were associated with an increased risk, whereas a higher proportion of linoleic acid (18:2 n-6) was protective against stroke/TIA. Further adjusting all models also for hypertension, diabetes, the metabolic syndrome, serum cholesterol, atrial fibrillation, cardiovascular disease, smoking, and physical activity, essentially the same pattern was observed. Conclusions-Indices of an unhealthy dietary fat intake and a high serum lipoprotein (a) level predicted fatal and nonfatal stroke/TIA independently of established risk factors in a community-based sample of middle-aged men followed for 32 years. (Stroke. 2006;37:2898-2903.)

Associations of serum n-3 and n-6 PUFA and hair mercury with the risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD)

“…Circulating fatty acids provide an objective measure of exposure, and are thus less subject to random error. However, previous studies that have used circulating PUFA as exposure have not produced consistent findings (6)(7)(8)(14)(15)(16)(17)(18)(19)(20)(21) . Therefore, the aim of our study was to investigate the associations between serum n-3 and n-6 PUFA and risk of stroke in men.…”

Serum fatty-acid composition and the risk of Alzheimer’s disease: a longitudinal population-based study

“…Due to the occurrence of any disease over time, the population at risk will be transformed into a population of survivors. The FA composition characterized by high levels of palmitoleic and oleic acids and low intake of linoleic acid is previously shown to be associated with mortality 8 and stroke 36 in the ULSAM cohort. Therefore, we sought to investigate the effect of competing risk by death in the present study.…”

The free fatty acid metabolome in cerebral ischemia following human mesenchymal stem cell transplantation in rats

“…The relative risk of FFA composition in serum samples has been studied in human cerebral ischemic events [17,20]. Iso et al reported that ischemic stroke is associated with changes in FFA; a higher intake of fish and n−3 polyunsaturated fatty acids is associated with a reduced risk of ischemic stroke, suggesting that FFA may have a role in protecting against ischemic stroke via a specific pathway in lipid metabolism [21].…”