国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Insulin resistance based on postglucose load measure is associated with prevalence and burden of cerebral small vessel disease
基本信息
- 负责人：Mengyuan Zhou,Suying Wang
- 数据来源： PRECISE
- 论文编号：PRECISE20210216
- 发表时间：2022-10-08
2022-10-08
已发表文章
发表杂志：BMJ Open Diabetes Research & Care
发表类型: Original Contributions
影响因子(IF): 4.179
PMID: 36220196 Pubmed原文链接 全文下载
主要研究背景及目的
Insulin resistance is critical in the development of macro- and micro-vascular events. The insulin sensitivity index (ISI0,120) was reported to be a better proxy for insulin resistance than the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), however, study of its association with cerebral small vessel disease (cSVD) is limited. This study aimed to estimate the association between insulin resistance and cSVD.
方法
Subjects are involved from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events study. We estimated the association of insulin resistance, assessed by the ISI0,120 and HOMA-IR based on the standard oral glucose tolerance test, with cSVD in those without history of diabetes mellitus. Cerebral SVD was measured for both main neuroimaging manifestations of cSVD and total SVD burden scores.
结论
A potential association was found between insulin resistance and cSVD, and the ISI0,120 index presented a greater association with increased risk of cSVD as compared to the HOMA-IR. However, these associations were greatly influenced by blood pressure and BMI.
主要结果
A total of 2752 subjects were enrolled. In the multivariable logistic regression analysis, the first quartile of ISI0,120 was found to be potentially associated with an increased risk of lacunes (OR 1.96, 95% CI 1.15 to 3.36), severe age-related white matter changes (OR 1.97, 95% CI 1.15 to 3.38), and higher total SVD burden (4-point scale: cOR 1.34, 95% CI 1.04 to 1.72; 6-point scale: cOR 1.43, 95% CI 1.14 to 1.79). The associations between HOMA-IR and lacunes (OR 1.90, 95% CI 1.11 to 3.25) and the 4-point scale of total SVD burden (cOR 1.33, 95% CI 1.04 to 1.70) were also significant after adjustment for age, gender, medical history, and medications. However, the associations were not statistically significant after further adjustment for blood pressure/hypertension and body mass index.