Association Between Metabolic Syndrome and Asymptomatic Cerebral Arterial Stenosis: A Cross-Sectional Study in Shandong, China

Abstract

Metabolic syndrome (MetS) can worsen cerebral arterial atherosclerosis stenosis in patients with stroke; however, its effect on patients without stroke remains ambiguous. This study explored the association of MetS and its individual components with asymptomatic intracranial arterial stenosis (aICAS) and asymptomatic extracranial arterial stenosis (aECAS) among older Chinese adults. A total of 1988 participants from the Kongcun Town study aged ≥40 years and without a history of stroke were enrolled. The baseline data were obtained via face-to-face interviews. MetS was defined according to International Diabetes Federation criteria. Detection of aICAS was conducted using transcranial Doppler ultrasound, followed by diagnosis via magnetic resonance angiography. The evaluation of aECAS was performed using bilateral carotid ultrasonography. The aICAS and aECAS groups were 1:1 matched separately to the non-stenosis group by age and sex. The association between MetS and aICAS or aECAS was analyzed using multivariate logistic regression. Among the 1988 participants, 909 were diagnosed with MetS. The prevalence of MetS was higher in the aICAS group than in the non-stenosis group (P <0.001), but did not differ significantly between the aECAS and non-stenosis groups. The prevalence of aICAS increased with the number of MetS components from 3.4% in the ≤ 1 component group to 12.7% in the ≥4 components group (P for trend <0.001). After adjusting for confounding factors, MetS components associated with aICAS included central obesity, elevated triglyceride levels, and elevated blood pressure. None of the MetS components was associated with aECAS. MetS was positively associated with aICAS, but not with aECAS. Further, different components play different roles in the pathological process leading to aICAS.

Keywords: asymptomatic cerebral arterial stenosis; asymptomatic extracranial arterial stenosis; asymptomatic intracranial arterial stenosis; metabolic syndrome; stroke primary prevention.

Figure 1

Multivariate logistic regression analysis of the association of MetS with aICAS or aECAS. aICAS, asymptomatic intracranial arterial stenosis; aECAS, asymptomatic extracranial arterial stenosis; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; BMI, body mass index; BP, blood pressure; MetS, metabolic syndrome; OR, odds ratio. ORs were calculated using logistic regression model after adjusting total cholesterol, BMI, and LDL-C.

Figure 2

Prevalence of aICAS and aECAS according to the number of MetS components. aICAS, asymptomatic intracranial arterial stenosis; aECAS, asymptomatic extracranial arterial stenosis; MetS, metabolic syndrome.