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Insulin Resistance and Muscle Weakness Are Synergistic Risk Factors for Silent Lacunar Infarcts: the Bunkyo Health Study: a Cross Sectional Study

Authors :
Kazunori Shimada
Daisuke Sugimoto
Nobutaka Hattori
Kazuo Kaneko
Yumiko Motoi
Satoshi Kadowaki
Ryuzo Kawamori
Muneaki Ishijima
Hideyoshi Kaga
Hiroyuki Daida
Shigeki Aoki
Yuki Someya
Hirotaka Watada
Ruriko Suzuki
Yoshifumi Tamura
Shuko Nojiri
Publication Year :
2021
Publisher :
Research Square Platform LLC, 2021.

Abstract

Background: Previous studies showed that insulin resistance and reduced muscle strength are risk factors for silent lacunar infarcts, but it is unclear whether they are still independent risk factors when adjusted for each other. In addition, the effect of their combination on silent lacunar infarcts is completely unknown.Methods: We evaluated silent lacunar infarcts, insulin sensitivity, and knee extensor muscle strength by magnetic resonance imaging, PREDIM (an index for insulin sensitivity), and dynamometer, respectively, in 1531 elderly people aged 65–84 years living in an urban area of Tokyo. Results: Among the study subjects, 251 (16.4%) had silent lacunar infarcts. Impaired insulin sensitivity (High; 1.00 [reference], Medium; 1.53 [95% confidence interval (CI): 0.94-2.48], Low; 1.86 [95%CI: 1.02-3.39], p for trend 0.047) and reduced muscle strength (High; 1.00 [reference], Medium; 1.40 [95%CI: 0.98-2.02], Low; 1.49 [95%CI: 1.04-2.15], p for trend 0.037) were independently associated with increased risk for silent lacunar infarcts in the fully adjusted model. In terms of combined, subjects classified as having the lowest insulin sensitivity and lowest strength were 4.33 times (95%CI: 1.64-11.45) more likely to have a silent lacunar infarct than those classified as having the highest insulin sensitivity and highest strength.Conclusions: Impaired insulin sensitivity and reduced muscle strength were independently associated with higher risk of silent lacunar infarcts in elderly subjects, and their combination synergistically increased this risk.

Details

Database :
OpenAIRE
Accession number :
edsair.doi...........ca44faf339523f41e74596c788b0fb65
Full Text :
https://doi.org/10.21203/rs.3.rs-297654/v1