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Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group.
J Neurol Sci. 2009 Sep 15; 284(1-2):40-5.JN

Abstract

BACKGROUND

Vascular localization of symptomatic large artery atherosclerotic (LAA) stroke differs for unknown reasons by race-ethnicity. The metabolic syndrome (MetSD) is associated with higher atherosclerotic stroke risk and comprises abnormal risk factors that can vary by race. Thus, we investigated whether MetSD may contribute to race-ethnic differences in LAA stroke by examining the association of MetSD with symptomatic intra- and extracranial atherosclerosis among a diverse race-ethnic group.

METHOD

We analyzed data prospectively collected over a 4-year period on subjects with ischemic stroke/TIA. Independent vascular risk factor associations with intracranial and extracranial LAA vs. non-LAA mechanism were evaluated in two groups stratified by race-ethnicity; whites and non-whites (Hispanics, African-American, and Asian-American).

RESULTS

1167 patients met study criteria. Intracranial LAA was more prevalent in non-whites vs. whites (20.4% vs. 9.6%, P<0.001), while extracranial LAA had a more frequent point value in whites compared to non-whites (10.7% vs. 7.5%, P=0.267). The presence of MetSD was more prevalent in both intracranial and extracranial LAA group than in non-LAA group: no significant differences were observed in the prevalence of MetSD between intra vs. extracranial LAA or whites vs. non-whites. However, with increasing numbers of abnormal metabolic components, whites were more likely to have experienced extracranial LAA, whereas non-whites were more likely to have experienced intracranial LAA. After adjusting for covariates, MetSD was associated with extracranial LAA in whites (OR, 1.98; 95% CI, 1.13-3.45), while there was a tendency that intracranial LAA was associated with MetSD in non-whites (OR, 1.80; 95% CI, 0.97-3.32). No association was found between MetSD and extracranial LAA in non-whites and between this syndrome with intracranial LAA in whites.

CONCLUSIONS

Our results showed that the impact of MetSD on the distribution of cervicocephalic atherosclerosis differed by race-ethnicity. This finding may in part explain the well-known differences in race-ethnic predilection to intracranial or extracranial atherosclerosis.

Authors+Show Affiliations

Department of Neurology, The Stroke and Cerebrovascular Center, Sungkyunkwan University, School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, South Korea. nmboy@unitel.co.krNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19398114

Citation

Bang, Oh Young, et al. "Impact of Metabolic Syndrome On Distribution of Cervicocephalic Atherosclerosis: Data From a Diverse Race-ethnic Group." Journal of the Neurological Sciences, vol. 284, no. 1-2, 2009, pp. 40-5.
Bang OY, Saver JL, Liebeskind DS, et al. Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group. J Neurol Sci. 2009;284(1-2):40-5.
Bang, O. Y., Saver, J. L., Liebeskind, D. S., Pineda, S., Yun, S. W., & Ovbiagele, B. (2009). Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group. Journal of the Neurological Sciences, 284(1-2), 40-5. https://doi.org/10.1016/j.jns.2009.03.033
Bang OY, et al. Impact of Metabolic Syndrome On Distribution of Cervicocephalic Atherosclerosis: Data From a Diverse Race-ethnic Group. J Neurol Sci. 2009 Sep 15;284(1-2):40-5. PubMed PMID: 19398114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of metabolic syndrome on distribution of cervicocephalic atherosclerosis: data from a diverse race-ethnic group. AU - Bang,Oh Young, AU - Saver,Jeffrey L, AU - Liebeskind,David S, AU - Pineda,Sandra, AU - Yun,Susan W, AU - Ovbiagele,Bruce, Y1 - 2009/04/26/ PY - 2008/12/24/received PY - 2009/03/06/revised PY - 2009/03/30/accepted PY - 2009/4/29/entrez PY - 2009/4/29/pubmed PY - 2009/12/16/medline SP - 40 EP - 5 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 284 IS - 1-2 N2 - BACKGROUND: Vascular localization of symptomatic large artery atherosclerotic (LAA) stroke differs for unknown reasons by race-ethnicity. The metabolic syndrome (MetSD) is associated with higher atherosclerotic stroke risk and comprises abnormal risk factors that can vary by race. Thus, we investigated whether MetSD may contribute to race-ethnic differences in LAA stroke by examining the association of MetSD with symptomatic intra- and extracranial atherosclerosis among a diverse race-ethnic group. METHOD: We analyzed data prospectively collected over a 4-year period on subjects with ischemic stroke/TIA. Independent vascular risk factor associations with intracranial and extracranial LAA vs. non-LAA mechanism were evaluated in two groups stratified by race-ethnicity; whites and non-whites (Hispanics, African-American, and Asian-American). RESULTS: 1167 patients met study criteria. Intracranial LAA was more prevalent in non-whites vs. whites (20.4% vs. 9.6%, P<0.001), while extracranial LAA had a more frequent point value in whites compared to non-whites (10.7% vs. 7.5%, P=0.267). The presence of MetSD was more prevalent in both intracranial and extracranial LAA group than in non-LAA group: no significant differences were observed in the prevalence of MetSD between intra vs. extracranial LAA or whites vs. non-whites. However, with increasing numbers of abnormal metabolic components, whites were more likely to have experienced extracranial LAA, whereas non-whites were more likely to have experienced intracranial LAA. After adjusting for covariates, MetSD was associated with extracranial LAA in whites (OR, 1.98; 95% CI, 1.13-3.45), while there was a tendency that intracranial LAA was associated with MetSD in non-whites (OR, 1.80; 95% CI, 0.97-3.32). No association was found between MetSD and extracranial LAA in non-whites and between this syndrome with intracranial LAA in whites. CONCLUSIONS: Our results showed that the impact of MetSD on the distribution of cervicocephalic atherosclerosis differed by race-ethnicity. This finding may in part explain the well-known differences in race-ethnic predilection to intracranial or extracranial atherosclerosis. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/19398114/Impact_of_metabolic_syndrome_on_distribution_of_cervicocephalic_atherosclerosis:_data_from_a_diverse_race_ethnic_group_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(09)00521-8 DB - PRIME DP - Unbound Medicine ER -