Significant associations of metabolic syndrome and its components with silent lacunar infarction in middle-aged subjects

Abstract

Background: Metabolic syndrome (MetS) is associated with an increased risk of ischemic stroke including silent brain infarction. No study has examined its association with the lacunar subtype alone. The present cross-sectional study examined the relations between MetS, its components and silent lacunar infarction (SLI) in middle-aged subjects.

Methods: We studied 2,076 subjects at ages between 40 and 59 years without a past history of stroke and clinical symptoms, who visited a health care facility for a routine health checkup and underwent brain magnetic resonance imaging. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel‡V report. A multiple logistic regression model was used to examine associations between MetS and SLI while adjusting for age, gender, a past history of ischemic heart disease, and current smoking.

Results: MetS was strongly associated with the presence of SLI [adjusted odds ratio (OR), 6.52; 95% confidence interval (CI), 4.30-9.90]. As for MetS components, elevated blood pressure, impaired fasting glucose, hypertriglyceridemia, and large waist circumference were significantly associated with SLI, independently of interrelationship between the components, while low high-density lipoprotein cholesterol was not significantly associated.

Conclusions: MetS was significantly associated with the prevalence of SLI in middle-aged persons. Not only elevated blood pressure and impaired fasting glucose, which are well-known risk factors of SLI, but also hypertriglyceridemia and large waist circumference were independent risk factors of SLI.