The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330006, China.
The Department of Geriatrics, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, Jiangxi, 330006, China.
BMC Public Health. 2024 Oct 9;24(1):2757. doi: 10.1186/s12889-024-20214-4.
Stroke is the leading cause of death in middle-aged and elderly people in China. Insulin resistance (IR) and sarcopenia are both closely associated with metabolic diseases. However, the relationship between these two indicators and stroke has not been fully investigated. The aim of this study was to investigate the relationship between IR and sarcopenia and the risk of new-onset stroke.
Using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, Cox proportional hazards models were used to determine the association between IR surrogate indicators and sarcopenia status with stroke incidence.
In the present study, during a median 7 years of follow-up, we included 7009 middle-aged and elderly residents, of whom 515 presented with stroke incidence. After adjustment for potential confounders, both baseline IR surrogates and sarcopenia independently predicted stroke risk. In addition, co-morbidities had a higher risk of stroke than other groups. The positive association between TyG-WC and sarcopenia on stroke risk was particularly significant [HR (95% CI): 2.03 (1.52, 2.70)]. In subgroups of different ages and sexes, the combination of IR and sarcopenia is associated with the highest risk of stroke.
We found that IR and sarcopenia synergistically increase the incidence of stroke in older adults. This finding provides new perspectives for stroke detection and intervention and highlights the importance of early detection and management of IR and sarcopenia in older adults.
中风是中国中老年人的主要致死原因。胰岛素抵抗（IR）和肌肉减少症均与代谢疾病密切相关。然而，这两个指标与中风之间的关系尚未得到充分研究。本研究旨在探讨 IR 和肌肉减少症与新发中风风险之间的关系。
利用 2011 年至 2018 年中国健康与退休纵向研究（CHARLS）的纵向数据，采用 Cox 比例风险模型确定 IR 替代指标和肌肉减少症状态与中风发生率之间的关联。
在本研究中，在中位 7 年的随访期间，共纳入 7009 名中老年居民，其中 515 人发生中风。在调整潜在混杂因素后，基线 IR 替代指标和肌肉减少症均独立预测中风风险。此外，合并症比其他组有更高的中风风险。TyG-WC 与肌肉减少症对中风风险的正相关关系尤为显著[HR（95%CI）：2.03（1.52，2.70）]。在不同年龄和性别的亚组中，IR 和肌肉减少症的联合与中风风险最高相关。
我们发现 IR 和肌肉减少症协同增加老年人中风的发生率。这一发现为中风的检测和干预提供了新的视角，并强调了早期检测和管理老年人的 IR 和肌肉减少症的重要性。
