Association of Serum Interleukin-34 and Insulin Resistance with Cognitive Impairment in Patients with Cerebral Small Vessel Disease

OBJECTIVE: Insulin resistance (IR) is a key pathological process during the development of cerebral small vessel disease (CSVD) and vascular cognitive impairment (VCI). The triglyceride- glucose index (TyG index) is considered a novel marker of insulin resistance and can represent peripheral tissue insulin sensitivity. Interleukin-34 (IL-34) is a cytokine of the short-chain helical hematopoietic cytokine family and recent studies have shown that its serum levels may represent an important biomarker for atherosclerosis. Here, we aimed to investigate whether the TyG index and serum IL-34 levels were related to VCI in patients with CSVD. METHODS: This study included a total of 280 CSVD patients. TyG index, clinical baseline data, and fasted venous blood for quantification serum levels of IL-34 were acquired within 24 hours of admission. Multiple logistic regression analysis was applied to analyze the association between potential risk factors and VCI, and receiver operator characteristic (ROC) curve was used to evaluate the diagnostic value of IL-34, TyG index, and their combination for detecting VCI. RESULTS: Among all included CSVD patients, 166 patients (59.3%) were diagnosed with VCI based on the cognitive function scale (MOCA). After adjusting for confounding factors, serum IL-34 levels and TyG index were independently associated with VCI (P<0.05). Using ROC curve analysis, the optimal thresholds for identification of VCI based on serum IL-34 levels and TyG index were 41.57pg/ml (area under the curve (AUC): 0.723; sensitivity 76.5%; specificity 64%) and 3.94 (AUC:0.727; sensitivity 72.3%; specificity 62.3%), respectively. CONCLUSION: This study demonstrated that IL-34 and TyG index are closely associated with VCI in CSVD patients and may represent clinical therapeutic targets for CSVD.