High dietary glycemic load was associated with the presence and burden of cerebral small vessel diseases in acute ischemic stroke patients

Abstract

Cerebral small vessel diseases (SVDs) are closely associated with stroke. Elevated postprandial blood glucose is also an important risk factor for stroke. Dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of postprandial blood glucose response used as an estimator of the overall glycemic effect of the diet. We hypothesized that high dietary GL or GI will be associated with presence of cerebral SVDs in patients with acute ischemic stroke. We prospectively included 263 patients who had experienced first-ever symptomatic cerebral infarction within 7 days after symptom onset and who submitted a fully filled-in semi-quantitative food frequency questionnaire. The dietary GL and GI values of food were constructed through an International table based on glucose. The presence and burden of high-grade white matter hyperintensities (HWMHs), cerebral microbleeds (CMBs), high-grade perivascular spaces (HPVSs) and asymptomatic lacunar infarctions (ALIs) were investigated. Mean age of the total patient population was 65.4 ± 11.7 years. After adjusting for age, sex, and variables with P < .1 in univariate analysis, high dietary GL was independently associated with an increased risk of presence of HWMHs (odds ratio (OR) (95% confidence interval (CI)) comparing the top quartile with the bottom quartile: 3.31 (1.37-7.98); P (for trend) = .006), CMBs (OR (95% CI): 3.06 (1.06-8.85); P = .032), PVSs (OR (95% CI): 3.24 (0.75-13.90); P = .039), and ALIs (OR (95% CI): 2.44 (0.97-6.13); P = .037). In conclusion, high dietary GL was associated with the presence and burden of cerebral SVDs in patients with acute cerebral infarction.

Keywords: Cerebral microbleeds; Cerebral small vessel disease; Glycemic index; Glycemic load; Perivascular spaces; White matter hyperintensities.