Insulin Resistance Is a Risk Factor for Silent Lacunar Infarction. Issue 12 (December 2016)

• Record Type: Journal Article
• Authors: Lee, Ji Eun; Shin, Dong Wook; Yun, Jae Moon; Kim, Sang Hyuck; Nam, You-Seon; Cho, BeLong; Lim, Jae-Sung; Jeong, Han-Yeong; Kwon, Hyung-Min; Park, Jin-Ho
• Is Part Of: Stroke. Volume 47:Issue 12(2016)
• Publication Date: 2016-12
• Subjects: infarction -- insulin resistance -- magnetic resonance imaging -- multivariate analysis -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.116.014097
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: This study aims to investigate the association between insulin resistance (IR) and silent lacunar infarction (SLI) in healthy adults. Methods—: We recruited 2326 healthy Korean adults who took health checkups, including a brain magnetic resonance imaging. SLI was defined as an infarction measuring 0.3 to 1.5 cm in diameter that was localized in the territory of perforating branches of cerebral arteries, as seen in the brain magnetic resonance imaging. The homeostasis model assessment–estimated insulin resistance index was used for IR estimation, and the cutoff value for its diagnosis for Koreans was 2.56. Results—: The mean age of the study population was 56.2 years (range, 40–79 years), and 1279 subjects (55.0%) were male. The prevalence of SLI and IR was 8.1% and 18.1%, respectively. In multivariate logistic analysis, after adjusting for traditional SLI-associated risk factors, IR was positively associated with the prevalence of SLI (adjusted odds ratio, 1.69; 95% confidence interval, 1.16–2.46). The proportion of subjects with multiple SLI lesions (≥2) was also higher in the IR (+) group than that in the IR (−) group (4.3% versus 1.7%; P <0.001). In ordered logistic regression, IR was positively associated with an increase in SLI severity (adjusted odds ratio, 1.76; 95% confidence interval, 1.21–2.56). Conclusions—: IR is an independent risk factor of SLI presence and its severity in Koreans. Whether improvement of IR might prevent SLI occurrence needs to be addressed by clinical trials. Abstract : Supplemental Digital Content is available in the text.