Correlation between insulin resistance and intracranial atherosclerosis in patients with ischemic stroke without diabetes.
BACKGROUND
Insulin resistance (IR) is associated with an increased risk for cardiovascular morbidity and mortality including ischemic stroke. Its final complications are cardiovascular and cerebrovascular disease caused by atherosclerosis. However, few studies on the relationship between IR and intracranial (IC) atherosclerosis have been reported.


METHODS
We analyzed 110 patients with acute stroke without diabetes who underwent brain magnetic resonance angiography and cerebral angiography. Patients were divided into 3 equal groups according to the tertiles of homeostasis model assessment of IR (HOMA-IR): group I (n = 36; HOMA-IR < 0.92), group II (n = 37; 0.92 <or= HOMA-IR < 1.55), and group III (n = 37; HOMA-IR >or= 1.55). Cerebral artery atherosclerosis was classified as either IC or extracranial (EC).


RESULTS
Patients with IC or EC atherosclerosis showed higher level of HOMA-IR than those without. When the association was assessed according to the site of atherosclerosis, HOMA-IR showed a significant association with the site of atherosclerosis (IC + EC > IC > EC, P < .01). Multivariate analysis revealed that HOMA-IR was an independent predictor of IC atherosclerosis.


CONCLUSIONS
Although the association between IR and stroke patterns in patients with atherosclerosis remains uncertain, IR is associated with IC atherosclerosis in patients with acute ischemic stroke without diabetes.
Park
Hyun-Young
HY
Department of Neurology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Jeonbuk, Korea. hypppark@hanmail.net
Kyeong-Ho
Park
Do-Sim
DS
Lee
Hak-Seung
HS
Chang
Hyuk
H
Kim
Yo-Sik
YS
Cho
Kwang-Ho
KH
D000328:Adult; D002545:Brain Ischemia / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006937:Hypercholesterolemia / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D006943:Hyperglycemia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D002537:Intracranial Arteriosclerosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology
D005947:Glucose