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The following is a summary of “Asymmetric U-shaped relationship between blood glucose and white matter lesions: results of a cross-sectional study,” published in the February 2025 issue of BMC Neurology by Liu et al. 

Elderly individuals are prone to White Matter Lesions (WMLs), linked to increased stroke, hemorrhage, and dementia risks. The relationship between blood glucose levels and WMLs remains inconsistent, with some studies suggesting glucose dysregulation contributes to WML formation. 

Researchers conducted a retrospective study to examine the relationship between blood glucose levels and WMLs in elderly individuals.  

They derived primary data from a predictive mathematical model to estimate WMLs based on parameters from routine medical examinations, with head MRI scans as the reference standard. They used multivariable logistic regression to analyze the relationship between blood glucose levels and WMLs and applied a restricted cubic spline regression model to examine a potential non-linear relationship. 

The results showed that among 1,904 participants, blood glucose levels and white matter lesions followed an asymmetric U-shaped curve (P for non-linearity = 0.004). Compared to the 2nd and 3rd quartiles (95-107 mg/dl), the 1st quartile (OR, 1.71; 95% CI: 1.26–2.30) and 4th quartile (OR, 1.57; 95% CI: 1.12–2.20) had significantly higher white matter lesions. 

Investigators found an asymmetric U-shaped relationship between blood glucose and WMLs, with the lowest risk at 95–107 mg/dl. The study’s cross-sectional design limited causal inference, and reliance on pre-existing data constrained variable availability. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04077-9#Abs1