Combined effect of chronic inflammation and insulin resistance on stroke: a cohort study and mediation analysis

作者：Yu Gao, Zhiping Duan, Jingkuo Li, Sicheng Du, Lijun Song, Ran Zhao, Yan Hou, Yan Zhao, Ying Li · 发表于：European journal of medical research · 年份：2025 · DOI：10.1186/s40001-025-03375-9 · 被引用次数：2 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Neuroinflammation and Neurodegeneration Mechanisms、Acute Ischemic Stroke Management

BACKGROUND: Stroke is a major public health challenge, and the combined effects of chronic inflammation and insulin resistance (IR) on stroke require further investigation. This study used high-sensitivity C-reactive protein (hsCRP) and the metabolic score for insulin resistance (MetS-IR) to assess chronic inflammation and IR, respectively, and explored their combined effects on stroke in middle-aged and older Chinese adults. METHODS: Based on the China Health and Retirement Longitudinal Study cohort, 7,422 participants ≥ 40 years old without stroke at baseline in 2011 were enrolled and followed up to 2020. MetS-IR was calculated from (ln 2 × fasting plasma glucose + triglyceride × body mass index)/ln high-density lipoprotein cholesterol. Participants were divided into four groups based on hsCRP (cut point 1 mg/L) and MetS-IR (cut point 34.4). Cox proportional risk modeling and mediation analysis were used to explore the effect of different inflammation and IR states on stroke. RESULTS: During an average follow-up period of 8.6 years, a total of 781 (10.5%) participants experienced a new stroke. Compared with participants with lower levels of both chronic inflammation and IR, the hazard ratio (HR) and 95% confidence interval (CI) for stroke in the higher chronic inflammation group was 1.64 (1.31-2.07), the HR and 95%CI for the higher IR group was 1.51 (1.19-1.90), and for the group with both higher levels of chronic inflammation and IR it was 1.95 (1.58-2.41). In addition, IR...