Insulin resistance, muscle weakness and silent strokes

A silent stroke has mild symptoms that it is often ignored. They are usually seen on a head CT scan as incidental findings.

Silent strokes are warning signs of fatal and non-fatal strokes. With time, the brain tissue damage accumulates with silent strokes and manifests as vascular dementia.

Silent stroke prevention is possible if the underlying cause is known.

This article presents a study showing that after total adjustment for all the potential risk factors, insulin resistance and muscle weakness are associated with an increased risk for silent lacunar infarcts.

In addition, the authors found that subjects with the lowest insulin sensitivity and muscle strength had a 4.33-fold higher risk for silent lacunar infarcts than those in the groups with the highest values for both parameters.

What is Insulin Resistance?

Insulin resistance is when the liver and muscle cells are not sensitive or do not respond to the normal insulin levels after eating. Insulin resistance and low insulin sensitivity are the same.

More at: What is Insulin Resistance?

Insulin is a hormone secreted by the pancreas and stores the fat, proteins, and carbohydrates we eat.

Insulin resistance makes the pancreas produce higher levels of insulin that are normally needed. What happens next is that there is more visceral fat stored inside the abdomen. Eventually, fatty liver, obesity, hyperinsulinemia, prediabetes, and adult-onset diabetes occur together with their complications.

In this study, insulin resistance was measured using PREDIM.

PREDIM is based on the derived oral glucose insulin sensitivity index (OGIS), Body Mass Index (BMI), 2-hour glucose during oral glucose tolerance test (OGTT), and fasting insulin.[2]

I don’t know any doctors that will order PREDIM for their patients. Here are two ways to measure insulin resistance using standard lab tests:

Going back to the research. The study involved 1,531 elderly subjects aged 65–84 in Tokyo, Japan. Muscle strength of the knee extensor muscles was tested with a dynamometer.

They used Magnetic Resonance Imaging (MRI) to identify lacunar infarcts, meaning that silent strokes have occurred in the past.

Lacunar infarcts are tiny. If they happen one at a time, they don’t produce the typical stroke symptom like the weakness of one side of the body or slurred speech.

Lacunar infarcts circled in red. By Prashanthsaddala. Source: Wikipedia

Study findings:

Among the study subjects, 251 (16.4%) had silent lacunar infarcts (SLI).
Impaired insulin sensitivity and reduced muscle strength were independently associated with increased risk for SLI.
When combined, subjects with the lowest insulin sensitivity and lowest strength were 4.33 times more likely to have an SLI than those with the highest insulin sensitivity and the highest strength.

This study agrees with a Korean study of 1,279 subjects that showed that people who are insulin resistant have a higher risk of silent lacunar infarcts. Moreover, those with worse insulin resistance tend to have more SLI lesions.[3]

How do we prevent silent strokes?

Avoid insulin resistance with intermittent fasting and resistance training.

There is no specific medicine that stops insulin resistance. Intermittent fasting can also reverse the need for insulin use in type 2 diabetes.

Resistance training or lifting weights increases muscle mass and prevents sarcopenia and frailty. Skeletal muscles can get bigger and increase in number even in advanced age.

Bodyweight exercises can be done at home with minimal equipment needed.

Contrary to common knowledge, the latest study shows that alcohol can shrink the brain. A drink a day shrinks the brain.

Lastly, one valid concern is the COVID-19 shots’ damage to the brain’s arteries. Will we see a sudden rise in people with dementia in the next five to ten years?

Learn more about exercises and their benefits at:

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References:

Someya, Yuki, et al. “Insulin resistance and muscle weakness are synergistic risk factors for silent lacunar infarcts: the Bunkyo Health Study.” Scientific reports vol. 11,1 21093. 26 Oct. 2021, doi:10.1038/s41598-021-00377-5
Tura A, Chemello G, Szendroedi J, Göbl C, Færch K, Vrbíková J, Pacini G, Ferrannini E, Roden M. Prediction of clamp-derived insulin sensitivity from the oral glucose insulin sensitivity index. Diabetologia. 2018 May;61(5):1135-1141. doi: 10.1007/s00125-018-4568-4. Epub 2018 Feb 26. PMID: 29484470.
Lee JE, Shin DW, Yun JM, Kim SH, Nam YS, Cho B, Lim JS, Jeong HY, Kwon HM, Park JH. Insulin Resistance Is a Risk Factor for Silent Lacunar Infarction. Stroke. 2016 Dec;47(12):2938-2944. doi: 10.1161/STROKEAHA.116.014097. Epub 2016 Nov 8. PMID: 27827330.

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