Correlation Between Insulin Resistance and Cerebral Microbleeds among Chinese Patients with Cerebral Small Vessel Disease.

Background and objectives: Insulin resistance (IR) plays an important role in the pathogenesis of cerebral small vessel disease (CSVD); however, little is known about the relationship between IR and the incidence of cerebral microbleeds (CMBs) in Asian populations. The aim of this study is to investigate the relationship between CMBs and IR in Chinese patients with CSVD. Methods: This retrospective study included 240 patients with CSVD. Patients were categorized by the homeostatic model assessment of insulin resistance (HOMA-IR): Quartile 1 (<= 1.26), Quartile 2 (1.27-1.92), Quartile 3 (1.93-2.89), and Quartile 4 (>2.89). The medical record of each patient was reviewed, and demographic, clinical and laboratory information was abstracted. All patients completed an MRI scan, and CMBs were defined as round or ovoid hypointense lesions on SWI sequence. Results: CMBs were present in 82 (34.17%) of the 240 patients that were included in the study (mean age, 71 years; male, 54.89%). After adjustment for potential confounding variables, insulin resistance was associated with the presence of CMBs (adjusted odds ratio 2.298, 95% confidence interval 1.017-5.194 for Q4:Q1; P = 0.046). According to receiver operating characteristic analysis, the best discriminating factor for CMBs was a HOMA-IR level >= 2.215 (area under the curve 0.595; sensitivity 51.2%; specificity 65.2%). Conclusions: IR is significantly associated with the presence of CMBs, suggesting the potential role of IR as a predictive marker for CMBs in patients with CSVD.