Association of insulin resistance with intra- and extra-cranial atherosclerotic burden in the nondiabetic community population

Xueli Cai; Jingping Sun; Aoming Jin; Jing Jing; Suying Wang; Lerong Mei; Xia Meng; Shan Li; Tiemin Wei; Yongjun Wang; Yuesong Pan

doi:10.1016/j.nbd.2023.106268

Association of insulin resistance with intra- and extra-cranial atherosclerotic burden in the nondiabetic community population

Neurobiol Dis. 2023 Oct 1:186:106268. doi: 10.1016/j.nbd.2023.106268. Epub 2023 Aug 23.

Authors

Xueli Cai¹, Jingping Sun¹, Aoming Jin², Jing Jing², Suying Wang³, Lerong Mei¹, Xia Meng², Shan Li³, Tiemin Wei⁴, Yongjun Wang², Yuesong Pan⁵

Affiliations

¹ Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China; Lishui Clinical Research Center for Neurological Diseases, Lishui, Zhejiang, China.
² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
³ Department of Neurology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China.
⁴ Department of Cardiology, The Central Hospital of Lishui, Lishui Hospital of Zhejiang University, Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China.
⁵ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China. Electronic address: yuesongpan@aliyun.com.

PMID: 37625526
DOI: 10.1016/j.nbd.2023.106268

Abstract

Aims: Few population-based studies have investigated the association between insulin resistance and atherosclerotic burden in intra- and extra-cranial arteries. The purpose of this study is to explore the relationship between insulin resistance and intra- and extra-cranial atherosclerotic burden in community-based nondiabetic participants.

Methods: This is a cross-sectional analysis from a population-based prospective cohort-PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study in China. The homeostasis model assessment of insulin resistance (HOMA-IR) and insulin sensitivity indices (ISI_0-120) were stratified by the quartiles, respectively. The atherosclerotic presence of plaques and burden was evaluated by high-resolution MRI. Binary or ordinal logistic regression was performed to assess the association between HOMA-IR or ISI_0-120 and the presence and burden of atherosclerosis.

Results: Among the 2754 participants, the mean age was 60.9 ± 6.6 years, and 1296 (47.1%) were males. Compared with the lowest quartile of HOMR-IR, the highest quartile of HOMA-IR (indicating a higher level of insulin resistance) was associated with an increased presence of plaques (OR:1.54, 95% CI:1.14-2.08), and atherosclerotic burden (OR:1.53, 95%CI:1.14-2.07) in intracranial arteries. Meanwhile, we observed a similar relationship between HOMA-IR and the presence or burden in extracranial atherosclerosis. The first (indicating a higher level of insulin resistance) quartiles of ISI_0-120 were associated with the intracranial plaques (Q1, OR:1.56, 95%CI:1.16-2.11) and atherosclerotic burden (Q1, OR:1.57, 95%CI:1.17-2.12), but not extracranial plaques or atherosclerotic burden, compared with the fourth quartile of ISI_0-120.

Conclusions: Insulin resistance was associated with an increased intra-and extra-cranial atherosclerotic burden in the nondiabetic elderly Chinese population.

Trial registration: ClinicalTrials.gov NCT03178448.

Keywords: Atherosclerotic burden; Extracranial plaques; Insulin resistance; Intracranial plaques.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Atherosclerosis* / epidemiology
Cross-Sectional Studies
Female
Humans
Insulin Resistance*
Male
Middle Aged
Plaque, Amyloid
Prospective Studies
Skull

Associated data

ClinicalTrials.gov/NCT03178448