Prevalence of Metabolic Syndrome and Its Associated Factors Among Malagasy Patients With Ischemic Stroke: A Cross-Sectional Study

Abstract

Introduction Metabolic syndrome (MetS) and ischemic stroke are significant public health issues due to their high prevalence and impact on morbidity and mortality. The objective of this study was to determine the prevalence of MetS and its associated factors among Malagasy patients with ischemic stroke. Materials and methods This cross-sectional study was conducted over a three-year period at the Soavinandriana Hospital Center, Antananarivo, Madagascar. MetS was defined according to the International Diabetes Federation's 2009 criteria. Ischemic stroke was confirmed by brain computerized tomography. The TOAST classification was used to determine the etiologies. Results We included 307 patients with ischemic stroke. The prevalence of MetS was 77.9%. According to the logistic regression analysis, the factors associated with MetS were female gender (adjusted odds ratio (aOR) = 3.99, p-value = 0.0031), hypertension (aOR = 4.02, p-value = 0.0029), overweight or obesity (aOR = 2.13, p-value = 0.0122), diabetes (aOR = 4.20, p-value = 0.0011), Glasgow scale ≤10 (aOR = 2.18, p-value = 0.0157), National Institutes of Health Stroke Scale (NIHSS) ≥15 (aOR = 2.94, p-value = 0.0086), and modified Rankin scale ≥ 3 (aOR = 2.29, p-value = 0.0033). As components of MetS, elevated blood pressure was significantly associated with overweight or obesity (aOR = 1.97, p-value = 0.0440), large artery atherosclerosis (LAA) (aOR = 10.2, p-value = 0.0256), and cardioembolism (aOR = 0.25, p-value = 0.0177). The associations between elevated fasting glucose and LAA (aOR = 2.26, p-value = 0.0012) and cardioembolism (aOR = 0.34, p-value = 0.0004). Elevated triglycerides was associated significantly with diabetes (aOR = 2.01, p-value = 0.0452), cardioembolism (aOR = 0.45, p-value = 0.0115), and lacunar infarcts (aOR = 3.05, p-value = 0.0336). Conclusion Screening for MetS should be a routine part of assessing patients with ischemic stroke. Proper management of MetS and its components could lead to improvements in the profile and prognosis of ischemic stroke.