Abstract:

Objective To explore the relationship between insulin resistance（IR），triglyceride ⁃glucose （Tyg）correlation index and cerebral microbleed（CMB）in patients with cerebral small vessel disease（CSVD），and to establish a predictive model. Methods A total of 130 patients with cerebral small vessel disease who were admitted to the Second Affiliated Hospital of Zhengzhou University from January 2021 to May 2022 were selected as clinical research subjects，and they were divided into CMB group（42 cases）and Non⁃CMB group（88 cases）. The basic clinical data of the patients were recorded and the IR ⁃ related indicators［triglyceride ⁃ glucose index （Tyg），triglyceride⁃glucose⁃BMI index（Tyg⁃BMI）］were recorded. Multivariate Logistic regression analysis was used to explore the influencing factors of CMB in patients with cerebral small vessel disease，and according to the results，a receiver operating characteristic（ROC）curve was drawn to evaluate its predictive value，and a nomogram prediction model was constructed. Results Fasting blood glucose，history of hypertension，Tyg and Tyg ⁃BMI in the CMB group were higher than those in the non⁃CMB group（P < 0.05）. Multivariate Logistic regression analysis showed that fasting blood glucose（OR = 1.388，95%CI：1.101 ~ 1.752，P = 0.006），history of hypertension（OR = 2.683，95%CI：1.041 ~ 6.916，P = 0.041），Tyg（OR = 5.808，95%CI：1.712 ~ 19.712，P = 0.005），Tyg⁃ BMI（OR = 1.034，95%CI：1.010 ~ 1.752，P=0.006）elevated were risk factors for developing CMB in patients with CSVD. A nomogram prediction model of CMB in patients with cerebral small vessel disease was established based on Tyg and Tyg⁃BMI. DCA was used for internal verification of clinical benefit，and the results suggest that the model had clinical benefit. The ROC curves of Tyg and Tyg⁃BMI for predicting the risk of CMB in patients with cerebral small vessel disease were drawn. The results showed that the area under the curve（AUC）of Tyg and Tyg⁃ BMI for predicting the risk of CMB in patients with cerebral small vessel disease were Tyg：0.700 respectively （95%CI：0.598 ~ 0.803，P < 0.01），Tyg⁃BMI：0.710（95%CI：0.618 ~ 0.802），P < 0.01）. Conclusions Insulin resistance may affect the risk of CMB in patients with cerebral small vessel disease. Insulin resistance⁃related indi⁃ cators（Tyg，Tyg⁃BMI）can have a certain predictive effect on the occurrence of CMB. Improving IR has a certain clinical value in preventing the occurrence of CMB.

Key words:

cerebral small vessel disease, cerebral microbleeds, insulin resistance, tyg index, nomogram