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
First author：Mengyuan Zhou,Suying Wang
Corresponding author：Yuesong Pan,Yilong Wang
essential_information
- Person in charge：Mengyuan Zhou,Suying Wang
- Data Sources： PRECISE
- Number of papers：PRECISE20210216
- Published time：2022-10-08
2022-10-08
Published articles
Journal：BMJ Open Diabetes Research & Care
Publication type: Original Contributions
IF(IF): 4.179
PMID: 36220196 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
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.
Main results
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.