Key result
Elderly subjects with the lowest insulin sensitivity and lowest muscle strength had a 4.33-fold higher odds of silent lacunar infarcts compared to those with the highest values for both parameters.
Why the study?
It is unclear whether insulin resistance and muscle weakness remain independent risk factors for silent lacunar infarcts when mutually adjusted, and their combined effect is unknown.
Do impaired insulin sensitivity and reduced muscle strength independently and synergistically increase the risk of silent lacunar infarcts in elderly adults?
Cross-Sectional (n=1,531)
No
Do impaired insulin sensitivity and reduced muscle strength independently and synergistically increase the risk of silent lacunar infarcts in elderly adults?
Odds Ratio: 4.33 (95% CI 1.64–11.45)
Impaired insulin sensitivity and reduced muscle strength are independent and synergistic risk factors for silent lacunar infarcts in elderly individuals.
Supports independent and synergistic associations with SLI in elderly; hypothesis-generating from cross-sectional data, needing prospective confirmation.
Insulin resistance and muscle weakness are risk factors for silent lacunar infarcts (SLI), but it is unclear whether they are still independent risk factors when adjusted for each other. In addition, the effect of their combination on SLI is completely unknown. We evaluated SLI, insulin sensitivity, and knee extensor muscle strength by magnetic resonance imaging, PREDIM, and dynamometer, respectively, in 1531 elderly people aged 65-84 years living in an urban area of Tokyo. Among the study subjects, 251 (16.4%) had SLI. Impaired insulin sensitivity (High; 1.00 [reference], Medium; 1.53 [95% confidence interval (CI) 0.94-2.48], Low; 1.86 [1.02-3.39], p for trend 0.047) and reduced muscle strength (High; 1.00 [reference], Medium; 1.40 [0.98-2.02], Low; 1.49 [1.04-2.15], p for trend 0.037) were independently associated with increased risk for SLI 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 SLI than those classified as having the highest insulin sensitivity and highest strength. Impaired insulin sensitivity and reduced muscle strength were independently associated with higher risk of SLI in elderly subjects, and their combination synergistically increased this risk.
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Someya et al. (2021) conducted a cross-sectional in Silent lacunar infarcts (n=1,531). Combined low insulin sensitivity and low muscle strength vs. High insulin sensitivity and high muscle strength was evaluated on Presence of silent lacunar infarcts (OR 4.33, 95% CI 1.64-11.45). Elderly subjects with the lowest insulin sensitivity and lowest muscle strength had a 4.33-fold higher odds of silent lacunar infarcts compared to those with the highest values for both parameters.
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