Insulin resistance increases stroke risk: a cross-sectional study from NHANES 1999-2018 and a Mendelian randomization study.

IF 1.7 4区医学 Q4 NEUROSCIENCES

International Journal of Neuroscience Pub Date : 2026-06-01 Epub Date: 2026-03-07 DOI:10.1080/00207454.2026.2641049

Yaxian Hu, Fei Zou, Zhen Zhou, Wei Lu

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引用次数: 0

Abstract

Background: Existing evidence suggested a relevance between insulin resistance (IR) and stroke, but further confirmation is needed. Research priorities encompass large sample size, stratified analysis, advanced IR index, stroke subtype characterization, and analysis of potential mechanisms.

Methods: We applied multivariable logistic regression using data from National Health and Nutrition Examination Survey 1999-2018 to estimate the correlation between two IR indexes: metabolic score for insulin resistance (METS-IR) and homeostasis model assessment of insulin resistance (HOMA-IR), and stroke. We also performed a two-sample Mendelian randomization (MR) study to detect the causal relationship between IR phenotype, METS-IR, and HOMA-IR as exposures, and stroke as well as its ischemic subtypes as outcomes.

Results: A total of 15,016 participants representing 147,325,838 individuals after weighting were enrolled. Both METS-IR and HOMA-IR were not significantly correlated with stroke after strict adjustment, but METS-IR was strongly related to stroke in individuals aged 20-40 in the stratification analysis. The MR analysis showed robust causal associations between IR phenotype and any stroke (AS) as well as ischemic stroke (IS). Besides AS and IS, METS-IR also had a causal effect on large artery stroke and small vessel stroke.

Conclusion: IR was associated with an increased risk of stroke in young adults.

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胰岛素抵抗增加卒中风险：NHANES 1999-2018的横断面研究和孟德尔随机研究

背景：现有证据表明胰岛素抵抗（IR）与脑卒中之间存在相关性，但需要进一步证实。研究重点包括大样本量、分层分析、先进的IR指数、脑卒中亚型表征和潜在机制分析。方法：利用1999-2018年全国健康与营养调查数据，采用多变量logistic回归方法估计胰岛素抵抗代谢评分（METS-IR）和胰岛素抵抗稳态模型评估（HOMA-IR）两项IR指标与卒中之间的相关性。我们还进行了一项双样本孟德尔随机化（MR）研究，以检测IR表型、met -IR和HOMA-IR作为暴露与卒中及其缺血性亚型之间的因果关系。结果：加权后共纳入15,016名参与者，代表147,325,838人。经严格调整后，met - ir和HOMA-IR与脑卒中均无显著相关性，但分层分析显示，met - ir与20-40岁人群脑卒中相关性较强。MR分析显示IR表型与任何中风（AS）以及缺血性中风（IS）之间存在强大的因果关系。除了AS和IS外，met - ir对大动脉卒中和小血管卒中也有因果影响。结论：IR与年轻人中风风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Neuroscience 医学-神经科学

CiteScore

5.10

自引率

0.00%

发文量

132

审稿时长

2 months

期刊介绍： The International Journal of Neuroscience publishes original research articles, reviews, brief scientific reports, case studies, letters to the editor and book reviews concerned with problems of the nervous system and related clinical studies, epidemiology, neuropathology, medical and surgical treatment options and outcomes, neuropsychology and other topics related to the research and care of persons with neurologic disorders. The focus of the journal is clinical and transitional research. Topics covered include but are not limited to: ALS, ataxia, autism, brain tumors, child neurology, demyelinating diseases, epilepsy, genetics, headache, lysosomal storage disease, mitochondrial dysfunction, movement disorders, multiple sclerosis, myopathy, neurodegenerative diseases, neuromuscular disorders, neuropharmacology, neuropsychiatry, neuropsychology, pain, sleep disorders, stroke, and other areas related to the neurosciences.