Abstract
The triglyceride glucose (TyG) index is considered a simple surrogate marker for insulin resistance and has been associated with cerebrovascular diseases. However, limited information is available regarding its association with the subclinical cerebral small vessel disease (CSVD). Here, we investigated the association of TyG index with the burden and distribution of enlarged perivascular space (EPVS) in the non-diabetic population. The data of 531 non-diabetic patients from 2017 to 2020 were assessed. Participants were grouped according to the burden of EPVS. TyG index was calculated using the log scale of fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2. The association of TyG index with EPVS burden and distribution was evaluated. In the multivariable logistic regression analysis, the TyG index was associated with moderate to severe EPVS [odds ratio (OR): 2.077; 95% CI = 1.268–3.403]. The TyG index was significantly associated with an increased risk of moderate to severe EPVS in subgroups of age <65 years, male, diastolic blood pressure (DBP) <90 mmHg, low-density lipoprotein cholesterol (LDL-C) ≥2.85 mmol/L, serum homocysteine <10 μmol/L, and estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m2, as well as those without smoking. Further analysis of EPVS distribution, the TyG index was found to be associated with moderate to severe EPVS in the centrum semiovale (CSO), not in the basal ganglia (BG). Conclusively, the TyG index was independently and positively associated with moderate to severe CSO EPVS. TyG index may serve as an independent risk factor for CSVD in clinical practice.
Highlights
Cerebral small vessel disease (CSVD) represents a cluster of pathologies with a heterogeneous etiology, which can affect the brain vascular system, such as small arteries, capillaries, and small veins
The triglyceride glucose (TyG) index was significantly correlated with Body mass index (BMI), hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL)-C, creatinine, uric acid, and estimated glomerular filtration rate (eGFR), but not white blood cell (WBC) and high-sensitivity C-reactive protein (hs-CRP). This is the first study to evaluate the relationship between Insulin resistance (IR) and enlarged perivascular space (EPVS) burden using the TyG index
In 531 patients of our study, 51.22% were observed to have moderate to severe EPVS
Summary
Cerebral small vessel disease (CSVD) represents a cluster of pathologies with a heterogeneous etiology, which can affect the brain vascular system, such as small arteries, capillaries, and small veins. CSVD can cause lacunar infarction and cerebral hemorrhage, which accounts for 20– 30% of symptomatic strokes [1, 2]. CSVD is recognized as an important cause of cognitive impairment, dementia, increased risk of stroke [4], and worse outcome after stroke [5]. It is the most common cause of vascular dementia, contributing to about 50% of dementias worldwide, and, is a massive health burden of stroke and dementia [4]. The possible mechanism of CSVD is arteriolosclerosis, lipohyalinosis, or fibrinoid necrosis of small vessels
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