Association between metabolic syndrome and previous ischemic lesions in patients with intracranial atherosclerotic stroke

Objectives To elucidate the relationship between MetS and ischemic stroke, we evaluated the association of MetS and individual components with frequency of ischemic stroke lesions and investigated the independent associations between them in acute ischemic stroke patients. Patients and methods We evaluated 370 acute ischemic stroke patients who underwent brain magnetic resonance (MR) imaging and MR angiography. The stroke subgroups were categorized as intracranial large artery atherosclerosis (IC-LAA, n = 151), extracranial large artery atherosclerosis (EC-LAA, n = 35), and nonatherosclerosis (NA, n = 184). MetS was defined using the criteria of the International Diabetes Federation. Results Patients with IC-LAA group showed a higher rate of MetS and previous ischemic lesions (predominantly deep gray/white matter) than those with EC-LAA and NA (all P < 0.001). The number of previous ischemic lesions showed a tendency to increase as the number of MetS components increased in the IC-LAA group (P = 0.004). In the IC-LAA group, age (OR, 1.04) and MetS (OR, 3.28) were independently associated with previous ischemic lesions (all P < 0.001), which was prominent with more severe MetS components after adjustment for risk factors (P < 0.001). Among the component conditions, high blood pressure, impaired fasting glucose, and abdominal obesity were more associated with previous ischemic lesions (all P < 0.001) than low high-density lipoprotein and high triglyceride levels (P = 0.010 and 0.028, respectively). Conclusion Our study showed a strong association between MetS and previous ischemic lesions, more in patients with IC-LAA.