Association of Carotid Atherosclerosis With White Matter Hyperintensity in an Asymptomatic Japanese Population: A Cross-Sectional Study.

Li Zhang,Jun Wen,Jun Xia,Li Hua Shao,Quan Zhou

doi:10.3389/fcvm.2021.665573

Li Zhang, Jun Wen + Show 3 more

Open Access

https://doi.org/10.3389/fcvm.2021.665573

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Abstract

Objective: A limited number of scholars concentrated on the relationship between carotid atherosclerosis (CAS) and white matter hyperintensity (WMH) (i.e., CAS-WMH relationship). The current research aimed to clarify the CAS-WMH relationship in Japanese population.Methods: All participants underwent MRI of head and ultrasonography of the carotid artery. WMH was diagnosed from MRI results. The carotid ultrasound findings, carotid artery plaque score (PS), and plaque number (PN) could be achieved to indicate the severity of CAS. We also employed multivariate logistic regression models to estimate the CAS-WMH relationship. Interaction and stratified analyses were undertaken on the basis of a number of factors (e.g., gender, age, smoking status, drinking habit, and history of chronic diseases).Results: A total of 1,904 Japanese subjects were included, and the prevalence of WMH was 54.8% (1,044/1,904). It was unveiled that frequency of CAS was greater in cases with WMH. In a fully adjusted model, high PS was associated with the frequency of WMH, followed by high PN. Further analyses revealed a dose-response relationship between PS and incidence of WMH.Conclusion: PS and PN exhibited the greatest influences on determining the frequency of WMH, highlighting the potentially important pathophysiological role of large artery atherosclerosis in intensifying WMH.

Highlights

Cerebral white matter hyperintensity (WMH) is an extremely frequent finding on magnetic resonance imaging (MRI) or computed tomography (CT) of brain in cases with stroke and dementia [1]
The WMH group showed higher age, lower male proportion, smoking habit, and drinking habit ratio, higher incidences of hypertension, hyperlipidemia, and diabetes mellitus, and a higher metabolic syndrome ratio, highdensity lipoprotein cholesterol (HDL-C), fasting plasma glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared to the non-WMH group
A recent meta-analysis revealed that WMH tended to be associated with carotid plaques and plaques or intima-media thickness (IMT) increased with elevation of WMH severity [13]

Summary

Introduction

Cerebral white matter hyperintensity (WMH) is an extremely frequent finding on magnetic resonance imaging (MRI) or computed tomography (CT) of brain in cases with stroke and dementia [1]. A number of scholars attempted to concentrate on WMH, efforts were made to identify association between WMH and factors that may influence WMH [2, 3]. Relationship Between Carotid Atherosclerosis and WMH pathologic thickening or necrosis of the vessel wall were noted to affect WMH [4, 5], while no information could be attained justifying how large-artery atherosclerosis may influence WMH. Insufficient cerebral perfusion due to CAS may affect the severity of WMH and increase the frequency of WMH [9]. WMH may be partially reversible in patients with carotid artery stenosis [10]. These findings highlight an important role of CAS in WMH as an intermediate factor, this conclusion remains controversial

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