The Difference in Role of Metabolic Vascular Risk Factors according to Ischemic Stroke Subtypes

Lee, Seong Min; Lee, Kee Ra; Kim, Myeong Kyu

Abstract

To investigate the roles of vascular risk factors associated with metabolic syndrome (MS) in ischemic stroke subtypes. A retrograde epidemiological and clinical analysis on stroke risk factors, including hypertension, diabetes mellitus, fibrinogen, uric acid, lipid profiles and body mass index etc, were performed with consecutive 335 stroke patients. Plasma fibrinogen concentration and various metabolic disorders failed to show any association with ischemic stroke subtypes, but higher uric acid concentration was strongly correlated with small vessel occlusive stroke (SVD). MS was closely related with female stroke patients and higher fibrinogen and apolipoprotein B (Apo B) level, and with increasing number of metabolic disorders characterizing MS, plasma fibrinogen concentration and body mass index were also increased significantly. In patients with MS, the characteristic findings of atherosclerotic dyslipimedia, higher triglyceride and lower HDL level, were documented. Even if mean serum LDL level of the patients with MS was similar to that of patients without MS, mean Apo B level was higher in the patients with MS than in patients without. Although its precise role in ischemic stroke is uncertain, higher uric acid level might be an independent risk factor for SVD. Hyperfibrinogenemia and high body mass index (>25 kg/m2) may be the components of MS. When other blood lipid profiles are normal, especially in patient with MS or type 2 diabetes mellitus, serum Apo B level should be evaluated lest atherogenic risk of cryptic dyslipidemia should be underestimated.