RT Journal Article SR Electronic T1 Insulin resistance based on postglucose load measure is associated with prevalence and burden of cerebral small vessel disease JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e002897 DO 10.1136/bmjdrc-2022-002897 VO 10 IS 5 A1 Mengyuan Zhou A1 Suying Wang A1 Jing Jing A1 Yingying Yang A1 Xueli Cai A1 Xia Meng A1 Lerong Mei A1 Jinxi Lin A1 Shan Li A1 Hao Li A1 Tiemin Wei A1 Yongjun Wang A1 Yuesong Pan A1 Yilong Wang YR 2022 UL http://drc.bmj.com/content/10/5/e002897.abstract AB Introduction Cerebral small vessel disease (cSVD) is highly prevalent and results in irreversible cognitive impairment and reduced quality of life. Previous studies reported controversial associations between insulin resistance and cSVD. Here, we estimated the association between insulin resistance and cSVD in non-diabetic communities in southeastern China.Research design and methods The Polyvascular Evaluation for Cognitive Impairment and Vascular Events study (NCT03178448) recruited 3067 community-dwelling adults. We estimated the association of insulin resistance, assessed by the insulin sensitivity index (ISI0,120) and the homeostatic model assessment for insulin resistance (HOMA-IR) based on the standard oral glucose tolerance test, with cSVD in those without a history of diabetes mellitus. cSVD was measured for both main neuroimaging manifestations of cSVD and total SVD burden scores.Results A total of 2752 subjects were enrolled. In the multivariable logistic regression analysis, the first quartile of ISI0,120 was found to be potentially associated with an increased risk of lacunes (OR 1.96, 95% CI 1.15 to 3.36), severe age-related white matter changes (OR 1.97, 95% CI 1.15 to 3.38), and higher total SVD burden (4-point scale: common OR (cOR) 1.34, 95% CI 1.04 to 1.72; 6-point scale: cOR 1.43, 95% CI 1.14 to 1.80). The associations between HOMA-IR and lacunes (OR 1.90, 95% CI 1.11 to 3.25) and the 4-point scale of total SVD burden (cOR 1.33, 95% CI 1.04 to 1.70) were also significant after adjustment for age, gender, medical history, and medications. However, the associations were not statistically significant after further adjustment for blood pressure/hypertension and body mass index (BMI).Conclusions A potential association was found between insulin resistance and cSVD, and the ISI0,120 index presented a greater association with increased risk of cSVD as compared with the HOMA-IR. However, these associations were greatly influenced by blood pressure and BMI.Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author on reasonable request. Supplementary data are available online.