Association of Metabolic Syndrome and Its Components With Risk of Stroke Recurrence and Mortality

作者：Fangfang Zhang, Lili Liu, Chun‐Dong Zhang, Shiliang Ji, Zubing Mei, Tian Li · 发表于：Neurology · 年份：2021 · DOI：10.1212/wnl.0000000000012415 · 被引用次数：142 · 研究领域：Acute Ischemic Stroke Management、Diabetes, Cardiovascular Risks, and Lipoproteins、Intracerebral and Subarachnoid Hemorrhage Research

Objective Because metabolic syndrome is a significant risk factor for cardio-cerebrovascular diseases and the relationship between metabolic syndrome (including its components) and the prognosis of stroke is controversial, this study was conducted to evaluate whether metabolic syndrome is associated with a high recurrence and mortality of stroke. Methods This study was registered in the PROSPERO database (CRD42020177118). We searched for relevant observational cohort studies published from inception to April 23, 2020, using PubMed, Embase, and the Cochrane Library. Effect estimates with 95% confidence intervals (CIs) were pooled using the random-effects model. The primary and secondary outcomes were stroke recurrence and all-cause mortality, respectively. Leave-one-out sensitivity analyses and nonparametric trim-and-fill method were used to identify the stability of the results. Results Thirteen cohort studies comprising 59,919 participants >60 years of age were included for analysis. Overall, metabolic syndrome was significantly associated with stroke recurrence (relative risk [RR] 1.46, 95% CI 1.07–1.97, p = 0.02). Among the metabolic syndrome components, low levels of high-density lipoprotein cholesterol (HDL-C) (RR 1.32, 95% CI 1.11–1.57, p = 0.002) and ≥2 metabolic syndrome components (RR 1.68, 95% CI 1.44–1.94, p < 0.001) significantly predicted stroke recurrence, whereas elevated triglycerides, elevated waist circumference, hyperglycemia, and hypertension failed to acc...