Metabolic Syndrome as a Risk Factor in Latin American Patients with Intracerebral Hemorrhage
Juan Carlos Ayala-Alvarez1, Iván Roque-Sánchez1, Enrique Gómez-Figueroa1, Omar Cárdenas-Saenz1, Amado Jiménez-Ruiz1, José Luis Ruiz-Sandoval1, Antonio Arauz-Góngora2, Fabiola Serrano-Arias2
1Neurology, Hospital Civil Fray Antonio Alcalde, 2Neurología, Instituto Nacional de Neurología y Neurocirugía
Objective:

OBJECTIVE

To analyze those risk factors associated with metabolic syndrome in patients with intracerebral hemorrhage. 

Background:

BACKGROUND

Intracerebral hemorrhage (ICH) is a public health problem that generates high morbidity and mortality in Mexico and Latin America. Metabolic syndrome (MS) is a risk factor for cardiovascular disease and ischemic stroke, but in ICH only the association between arterial hypertension and worse clinical outcomes is recognized. 

Design/Methods:

Data from three, longitudinal multicenter, Latin American retrospective registries of cerebral vascular disease, with a total of 1130 subjects with ICH, were analyzed. To define the association of the different components of the metabolic syndrome with good prognosis, poor prognosis and death, logistic regression models were used and odd ratios (OR) were calculated according to the exponent of the resulting coefficient. Significant values when p< 0.05. 

Results:

In the univariate analysis for good prognosis, we identified an increased probability in patients with previous history of hypertension and smoking (1.74 [1.09-2.92] p=0.024) and (1.43 [1.03-1.93] p=0.027), respectively.

 

When assessing poor prognosis, only smoking history represented a protective factor (0.71 [0.53-0.96] p=0.030). Previous history of DM adjusted for metabolic syndrome and age was associated with an increased chance of reaching mRS 3-5 at discharge (1.37 [1.02-1.83] P=0.032) and (0.38 [1.03-1.84] P=0.030)respectively.

 

Finally, only obesity was associated with an increased risk of death (1.36 [1.05-1.76], P=0.017).

Conclusions:

Metabolic syndrome factors in the Latino population play an important role in the functional prognosis of patients with intracerebral hemorrhage. Although hypertension is a risk factor, the fact of being hypertensive and having a previous management could predispose to a better prognosis. Diabetes mellitus itself predisposes to greater complications during hospitalization. Obesity is also attributed to be the cause of a worse functional status, as well as an unfavorable outcome due to the increase in morbidity and mortality.

10.1212/WNL.0000000000201990