Association Between Triglyceride-Glucose Index And Enlarged Perivascular Spaces In Non-Diabetic Patients

Background:Triglyceride-glucose(TyG)index is a simple index of insulin resistance(IR),which is associated with cardiovascular and cerebrovascular diseases.Enlarged perivascular spaces(EPVS)is one of the imaging markers of cerebral small vessel disease(CSVD),which is closely related to the prognosis of vascular dementia,lacunar infarction,post-stroke depression and other diseases.However,the relationship between TyG index and the occurrence of EPVS is not clear.In this project,we investigated the correlation between TyG index and the severity and distribution of EPVS in non-diabetic patients.Methods:A total of 531 non-diabetic patients who visited the Department of Neurology of our hospital from July 2017 to December 2020 were selected.All patients underwent head MRI and laboratory hematological examination.Two trained neurologists who were blinded to the baseline data independently assessed EPVS.EPVS was graded according to the number of lesions and divided into mild moderate to severe group according to the severity.Relevant risk factors such as patient age,smoking history,drinking history,hypertension history,body mass index,triglycerides,fasting blood glucose,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and homocysteine were collected.TyG index was calculated as ln[fasting triglycerides(mg/dl)×fasting blood glucose(mg/dl)/2].The correlation between TyG index and EPVS was analyzed using the Chi-square test,Kruskal-Wallis test,Mann-Whitney U test,Spearman correlation analysis,and logistic regression analysis.Results:Spearman correlation coefficient analysis of EPVS severity and TyG index showed that EPVS severity was positively correlated with TyG index.Multivariate logistic regression analysis of EPVS severity showed that TyG index(OR 2.077,95%CI 1.268-3.403;p=0.004),smoking(OR 2.130,95%CI 1.222-3.710;p=0.008),and hypertension(OR 2.068,95%CI 1.348-3.172;p=0.001)were independently associated with moderate to severe EPVS.Stratified analysis and interaction analysis of EPVS severity showed that after adjusting for other confounders,age<65 years(OR 3.684;95%CI 1.762-7.699;p=0.001),male gender(OR 2.157;95%CI 1.142-4.073;p=0.018),diastolic blood pressure<90 mm Hg(OR 2.247;95%CI 1.123-4.495;p=0.022),non-smoking(OR 2.046;95%CI 1.123-3.727;p=0.019),low-density lipoprotein cholesterol≥2.85 mmol/L(OR 3.049;95%CI 1.577-5.895;p=0.001),homocysteine<10μmol/L(OR 2.734;95%CI 1.264-5.915;p=0.011),and glomerular filtration rate<90 m L/min/1.73m~2(OR 2.473;95%CI 1.104-5.540;p=0.022)showed no significant interaction with other moderate-to-severe risk factors,but no significant interaction with EPVS risk index.Correlation analysis between TyG index and EPVS at different sites revealed that after logistic regression analysis,TyG index(OR 1.936,95%CI 1.236-3.032;p=0.004)and moderate to severe centrum semiovale enlarged perivascular spaces(CSO-EPVS)were independently associated,but not with basal ganglia enlarged perivascular spaces(BG-EPVS).Conclusion:1.In non-diabetic patients,TyG index,smoking and hypertension were significantly correlated with EPVS.TyG index may be an independent risk factor for EPVS in non-diabetic patients.2.TyG index was correlated with EPVS in the semioval region,but not with EPVS in the basal ganglia.