Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study

Jennifer L. Dearborn, Andrea L C Schneider, A. Richey Sharrett, Thomas H. Mosley, Daniel C. Bezerra, David S Knopman, Elizabeth Selvin, Clifford R Jr. Jack, Laura H. Coker, Alvaro Alonso, Lynne E. Wagenknecht, Beverly G. Windham, Rebecca F. Gottesman

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background and Purpose-The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Methods-Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings ≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Results-Metabolic syndrome (adjusted odds ratio, 1.98; 95% confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95% confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. Conclusions-The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease.

Original languageEnglish (US)
Pages (from-to)3131-3136
Number of pages6
JournalStroke
Volume46
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Insulin Resistance
Atherosclerosis
Obesity
Magnetic Resonance Imaging
Abdominal Obesity
Body Mass Index
Odds Ratio
Confidence Intervals
Insulin
Waist Circumference
Principal Component Analysis
Cluster Analysis
White Matter
Logistic Models
Brain

Keywords

  • atherosclerosis
  • body mass index
  • obesity
  • risk factors
  • white matter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Dearborn, J. L., Schneider, A. L. C., Sharrett, A. R., Mosley, T. H., Bezerra, D. C., Knopman, D. S., ... Gottesman, R. F. (2015). Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study. Stroke, 46(11), 3131-3136. https://doi.org/10.1161/STROKEAHA.115.010060

Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging : Atherosclerosis Risk in Communities Study. / Dearborn, Jennifer L.; Schneider, Andrea L C; Sharrett, A. Richey; Mosley, Thomas H.; Bezerra, Daniel C.; Knopman, David S; Selvin, Elizabeth; Jack, Clifford R Jr.; Coker, Laura H.; Alonso, Alvaro; Wagenknecht, Lynne E.; Windham, Beverly G.; Gottesman, Rebecca F.

In: Stroke, Vol. 46, No. 11, 01.11.2015, p. 3131-3136.

Research output: Contribution to journalArticle

Dearborn, JL, Schneider, ALC, Sharrett, AR, Mosley, TH, Bezerra, DC, Knopman, DS, Selvin, E, Jack, CRJ, Coker, LH, Alonso, A, Wagenknecht, LE, Windham, BG & Gottesman, RF 2015, 'Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study', Stroke, vol. 46, no. 11, pp. 3131-3136. https://doi.org/10.1161/STROKEAHA.115.010060
Dearborn, Jennifer L. ; Schneider, Andrea L C ; Sharrett, A. Richey ; Mosley, Thomas H. ; Bezerra, Daniel C. ; Knopman, David S ; Selvin, Elizabeth ; Jack, Clifford R Jr. ; Coker, Laura H. ; Alonso, Alvaro ; Wagenknecht, Lynne E. ; Windham, Beverly G. ; Gottesman, Rebecca F. / Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging : Atherosclerosis Risk in Communities Study. In: Stroke. 2015 ; Vol. 46, No. 11. pp. 3131-3136.
@article{34623741a2a64ad99a0b4f8356645a78,
title = "Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study",
abstract = "Background and Purpose-The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Methods-Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings ≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Results-Metabolic syndrome (adjusted odds ratio, 1.98; 95{\%} confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95{\%} confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. Conclusions-The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease.",
keywords = "atherosclerosis, body mass index, obesity, risk factors, white matter",
author = "Dearborn, {Jennifer L.} and Schneider, {Andrea L C} and Sharrett, {A. Richey} and Mosley, {Thomas H.} and Bezerra, {Daniel C.} and Knopman, {David S} and Elizabeth Selvin and Jack, {Clifford R Jr.} and Coker, {Laura H.} and Alvaro Alonso and Wagenknecht, {Lynne E.} and Windham, {Beverly G.} and Gottesman, {Rebecca F.}",
year = "2015",
month = "11",
day = "1",
doi = "10.1161/STROKEAHA.115.010060",
language = "English (US)",
volume = "46",
pages = "3131--3136",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging

T2 - Atherosclerosis Risk in Communities Study

AU - Dearborn, Jennifer L.

AU - Schneider, Andrea L C

AU - Sharrett, A. Richey

AU - Mosley, Thomas H.

AU - Bezerra, Daniel C.

AU - Knopman, David S

AU - Selvin, Elizabeth

AU - Jack, Clifford R Jr.

AU - Coker, Laura H.

AU - Alonso, Alvaro

AU - Wagenknecht, Lynne E.

AU - Windham, Beverly G.

AU - Gottesman, Rebecca F.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background and Purpose-The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Methods-Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings ≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Results-Metabolic syndrome (adjusted odds ratio, 1.98; 95% confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95% confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. Conclusions-The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease.

AB - Background and Purpose-The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Methods-Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings ≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Results-Metabolic syndrome (adjusted odds ratio, 1.98; 95% confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95% confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. Conclusions-The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease.

KW - atherosclerosis

KW - body mass index

KW - obesity

KW - risk factors

KW - white matter

UR - http://www.scopus.com/inward/record.url?scp=84945898587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945898587&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.115.010060

DO - 10.1161/STROKEAHA.115.010060

M3 - Article

C2 - 26451022

AN - SCOPUS:84945898587

VL - 46

SP - 3131

EP - 3136

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 11

ER -