Ji Eun Lee1, Dong Wook Shin1, Jae Moon Yun1, Sang Hyuck Kim1, You-Seon Nam1, BeLong Cho1, Jae-Sung Lim1, Han-Yeong Jeong1, Hyung-Min Kwon2, Jin-Ho Park2. 1. From the Department of Family Medicine (J.E.L., D.W.S., J.M.Y., S.H.K., Y.-S.N., B.C., J.-H.P.) and Health Promotion Center (J.E.L., D.W.S., J.M.Y., S.H.K., Y.-S.N., B.C., J.-H.P.), Seoul National University Hospital, Republic of Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea (J.-S.L.); Department of Neurology, Aerospace Medical Center, Cheongju, Republic of Korea (H.-Y.J.); and Department of Neurology, Seoul National University-Seoul Municipal Government Boramae Medical Center, Republic of Korea (H.-M.K.). 2. From the Department of Family Medicine (J.E.L., D.W.S., J.M.Y., S.H.K., Y.-S.N., B.C., J.-H.P.) and Health Promotion Center (J.E.L., D.W.S., J.M.Y., S.H.K., Y.-S.N., B.C., J.-H.P.), Seoul National University Hospital, Republic of Korea; Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea (J.-S.L.); Department of Neurology, Aerospace Medical Center, Cheongju, Republic of Korea (H.-Y.J.); and Department of Neurology, Seoul National University-Seoul Municipal Government Boramae Medical Center, Republic of Korea (H.-M.K.). kkolzzi0@gmail.com hmkwon@snu.ac.kr.
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.
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.
Authors: Dana R Jorgensen; C Elizabeth Shaaban; Clayton A Wiley; Peter J Gianaros; Joseph Mettenburg; Caterina Rosano Journal: Am J Physiol Heart Circ Physiol Date: 2018-02-02 Impact factor: 4.733
Authors: Zoe Arvanitakis; Ana W Capuano; Hoau-Yan Wang; Julie A Schneider; Alifiya Kapasi; David A Bennett; Rexford S Ahima; Steven E Arnold Journal: Acta Neuropathol Commun Date: 2021-04-15 Impact factor: 7.801
Authors: Sini Toppala; Laura L Ekblad; Jyrki Lötjönen; Semi Helin; Saija Hurme; Jarkko Johansson; Antti Jula; Mira Karrasch; Juha Koikkalainen; Hanna Laine; Riitta Parkkola; Matti Viitanen; Juha O Rinne Journal: J Alzheimers Dis Date: 2019 Impact factor: 4.472