Metabolic Syndrome as an Independent Risk Factor of Silent Brain Infarction in Healthy People

Abstract

Background and Purpose-Metabolic syndrome (MetS) is associated with an increased risk of the subsequent development of cardiovascular disease or stroke. Moreover, a silent brain infarction (SBI) can predict clinical overt stroke or dementia. We examined the associations between SBI and MetS in apparently healthy individuals. Methods-We evaluated 1588 neurologically healthy subjects (927 males and 661 females) who underwent brain MRI at Seoul National University Hospital Healthcare System Gangnam Center. MetS was defined using the criteria of the National Cholesterol Education Program Adult Treatment Panel III. We examined associations between full syndrome (Ն3 of the 5 conditions) as well as its components and SBI by controlling possible confounders. Results-Eighty-eight (5.5%) were found to have Ն1 SBI on MRI. Age was found to be significantly related to SBI prevalence (odds ratio [OR], 1.06; 95% CI, 1.04 to 1.09). A history of coronary artery disease was associated with an elevated odds ratio of SBI (OR, 2.83; 95% CI, 1.38 to 5.82), and MetS was significantly associated with SBI (OR, 2.18; 95% CI, 1.38 to 3.44). The components model of MetS showed a strong significance between an elevated blood pressure (OR, 3.75; 95% CI, 2.05 to 6.85) and an impaired fasting glucose (OR, 1.74; 95% CI, 1.08 to 2.80) and the risk of SBI. Key Words: cerebral infarction Ⅲ magnetic resonance imaging Ⅲ metabolic syndrome x Ⅲ risk factors S ilent brain infarction (SBI) is defined as a cerebral infarction that is evident by brain imaging but that is without a clinical syndrome characterized by rapidly developing clinical symptoms and signs of focal and at times a global loss of brain function. 1 SBI is frequently seen on MRIs in healthy elderly people. The prevalence of these asymptomatic lesions increases with age from Ϸ5% at 60 years of age to 35% at 90 years of age. [2][3][4] The presence of an SBI can predict clinical overt stroke 2,5 or reduced cognitive functioning. 3,6 To prevent SBI, it is important that its risk factors be identified, especially treatable factors. It has been demonstrated that the risk factors of SBI are not necessarily the same as those of clinical stroke, 7 and several studies have consistently found that regardless of race, advanced age 2,5,8 -12 and hypertension 2,4 -11 are the most common risk factors for SBI. Conclusions-MetSThe combination of cardiovascular risk factors that compose metabolic syndrome (MetS) are receiving increasing attention from physicians, but no data are available on the association of the syndrome with SBI. A set of metabolic and physiological risk factors linked to cardiovascular disease has been variously defined as insulin resistance syndrome, syndrome X, the deadly quartet, MetS, dysmetabolic syndrome, and cardiovascular dysmetabolic syndrome. [13][14][15][16][17] Proposed definitions of MetS differ with respect to its components and component set points. However, recent attempts to define MetS have included 5 conditions: hyper-triglyceridemia (hyper-TG), low high-density li...

Metabolic Syndrome, Prediabetes, and Brain Abnormalities on MRI in Patients With Manifest Arterial Disease: The SMART-MR Study

“…Previous crosssectional studies showed no differences in brain volume between subjects with and without MetS (5,6), but high HbA 1c has been identified as a risk factor for a greater rate of brain atrophy over 6 years in a prospective study (7). For the relation of MetS with ischemic stroke, contradictory results have been reported (8)(9)(10)(11)(12), as well as for the relation of MetS with WMH (5,13). Not all of these studies used volumetric assessment of WMH and measures of brain atrophy.…”

Risk of “silent stroke” in patients older than 60 years: risk assessment and clinical perspectives

“…12 Another study revealed similar prevalence resulting in an age-adjusted SBI prevalence of 5.1% among 994 healthy adults (mean age 49.0 ± 7.7). 13 There were considerable discrepancies in the prevalence rates listed in these studies due to differences in age distribution and the presence of underlying cardiovascular diseases in the study population (Table 1).…”

“…40 These tendencies were confirmed in middle-aged subjects (adjusted OR [AOR] = 6.52; 95% CI: 4.30-9.90) and in normal healthy adults (mean age 53.6 years, ranged from 20 to 86 years; OR = 2.18; 95% CI: 1.38-3.44). 12,41 Both the full syndrome ($3 of the 5 components) and each of the components were correlated with SBI. It was 12 Though only BP and fasting blood glucose level are usually taken into consideration, TG and AC also need to be considered and should be managed properly to prevent the SBI.…”

“…12,41 Both the full syndrome ($3 of the 5 components) and each of the components were correlated with SBI. It was 12 Though only BP and fasting blood glucose level are usually taken into consideration, TG and AC also need to be considered and should be managed properly to prevent the SBI.…”

Association between common genetic variants of α2A-, α2B- and α2C-adrenoceptors and the risk of silent brain infarction

“…SBI has been associated with several cardiovascular risk factors. Previous studies strongly suggest that SBI can be significantly influenced by multiple risk factors, including hypertension, homocysteine levels, cigarette smoking and metabolic syndrome (7)(8)(9)(10)(11). However, relatively little is known about the genes involved in SBI pathogenesis.…”