Metabolic Syndrome in Polish Ischemic Stroke Patients.

BACKGROUND: Metabolic syndrome (MetS) predisposes individuals to cardiovascular disease or stroke development. We aimed at evaluating the prevalence of MetS in a population of acute ischemic stroke (IS) patients from central Poland and at estimating the relationship between MetS and stroke risk. METHODS: We analyzed 672 IS patients who were consecutively admitted to stroke units. The control group was composed of 612 patients with other neurologic disorders. MetS was diagnosed if 3 of 5 factors were present (obesity, increased blood pressure, increased triglycerides, low high-density lipoprotein [HDL] cholesterol, and fasting hyperglycemia) according to the Unified Criteria for Clinical Diagnosis of the Metabolic Syndrome (2009). RESULTS: MetS was diagnosed in 61.2% of stroke patients versus 18.1% of the control group (P < .001). Multiple logistic regression showed that MetS was 1.8 times more common in women than in men (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4-2.5). The adjusted OR (95% CI) associated with MetS was 2.44 (1.48-3.64; P < .001) for IS. Hypertension and hypertriglyceridemia were the most frequent disturbances of IS patients (87.2% and 68.2%, respectively). The analysis of the interaction between MetS and its components showed significant associations with hypertension (OR, 2.15; 95% CI, .98-4.24; P < .01), high triglyceride levels (OR, 4.35; 95% CI, 2.87-9.43; P < .0001), and low HDL cholesterol levels (OR, 5.12; 95% CI, 3.15-8.20; P < .001). CONCLUSIONS: Over 60% of Polish IS patients have MetS. The prevalence of MetS was significantly higher in women than in men. Thus, MetS may be a risk factor for IS.

[The role of vitamin D in the pathogenesis and course of multiple sclerosis]. / Wplyw witaminy D na patogeneze i przebieg stwardnienia rozsianego.

Multiple sclerosis (MS) is a progressive, inflammatory demyelinating disease of the central nervous system, with an unknown aetiology. The pathogenesis of MS is mainly related with the autoimmune process, environmental factors and genetic predispositions. In recentyears, hypovitaminosis D has been considered as an independent factor increasing the risk of multiple sclerosis. Hypovitaminosis D is defined as a condition in which the concentration of 25(OH)D in serum is lower than 75 nmol/l (30 ng/ml). Numerous studies have documented the relation between the occurrence of MS, its course and activity, and vitamin D concentration dependent on sunlight and dietary intake. Conclusions from research on the effectiveness of supplementation have also been presented. They indicate the necessity of using higher doses of calcitriol. Most authors consider a preventive dose of 4000 IU daily as safe and well-tolerated by people living in low-insolation latitudes. It has been pointed out that vitamin D supplementation is indicated and effective only in cases of actual deficiency. The low risk and low cost of vitamin D supplementation, as well as patients' positive attitude towards it, makes it a promising strategy for decreasing the incidence and alleviating the signs and symptoms of multiple sclerosis.