Insulin resistance, which plays a key role in the development of
diabetes mellitus, is a putative modifiable risk factor for
stroke. The aim of this study was to investigate if markers of
insulin resistance were associated with risk of
stroke in the general elderly population. This study was part of the large population-based Rotterdam Study and included 5,234 participants who were aged 55 years or older and
stroke free and diabetes free at baseline (1997-2001). Fasting
insulin levels and homeostasis model assessment for
insulin resistance were used as markers for
insulin resistance. Cox regression was used to determine associations between
insulin resistance markers and
stroke risk, adjusted for age, sex, and potential confounders. During 42,806 person-years of follow-up (median: 8.6 years), 366 first-ever
strokes occurred, of which 225 were
cerebral infarctions, 42 were
intracerebral hemorrhages, and 99 were unspecified
strokes. Fasting
insulin levels were not associated with risk of any
stroke, cerebral infarction, or
intracerebral hemorrhage. Homeostasis model assessment for
insulin resistance, which almost perfectly correlated with fasting
insulin levels, was also not associated with risk of
stroke or
stroke subtypes. In conclusion, in this population-based cohort study among nondiabetic elderly,
insulin resistance markers were not associated with risk of
stroke or any of its subtypes.