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Abstract
Intracranial hemorrhage or microbleeds and leukoaraiosis have an overlap in biology. Hyperlipidemia may reduce the risk of ICH or cerebral microbleeds; studies focusing on the relationship between different lipid profiles and severity of periventricular hyperintensities (PVH) and subcortical white matter lesions (SWMLs) in the cerebral small vessel disease are limited. Methods. Patients with recent first lacunar infarct were recruited. PVH and SWMLs were accessed on MRI with the Fazekas scale, and lipid levels were measured. Univariate and multivariable regression analyses were used to assess the relation between different lipid profiles and severity of PVH and SWMLs. Results. In univariate analyses, advancing age was correlated with increasing severity of leukoaraiosis (P < 0.001). There was an inverse relationship between hypertriglyceridemia (hyper-TG) (≥1.7 mmol/l) and severity of leukoaraiosis (P < 0.05). In the multivariable analysis, after controlling for age, sex, and significant risk factors in the univariate and age-adjusted analyses, hyper-TG demonstrated a protective effect on the severity of PVH and SWMLs (P < 0.05). Higher total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were not associated with leukoaraiosis. Conclusions. Hyper-TG is associated with the severity of leukoaraiosis independent of other risk factors, and it might be a protective role in cerebral small vessel disease.
Highlights
Leukoaraiosis, known as white matter hyperintensities, is strongly linked to the cerebral small vessel disease, which increases the risk of stroke, cognitive decline, dementia, and infarct progression [1, 2]
The abnormal signals with a high intensity are often divided into 2 categories: periventricular hyperintensity (PVH), which is about the cerebral ventricles, and subcortical white matter lesions (SWMLs), which are patchy areas of white matter hyperintensities in subcortical white matter distinct from the periventricular area [3]
We found that hyper-TG may be associated with reduced leukoaraiosis severity both in PVH and in SWML groups
Summary
Leukoaraiosis, known as white matter hyperintensities, is strongly linked to the cerebral small vessel disease, which increases the risk of stroke, cognitive decline, dementia, and infarct progression [1, 2]. The pathogenesis of leukoaraiosis is not completely elucidated, previous studies have shown that white matter lesions are more common in ageing patients, in patients with hypertension, diabetes mellitus, and cerebral vessel atherosclerosis, and in patients with a history of stroke [1, 4]. Hyperlipidemia appears to have a different role in intracranial hemorrhage and cerebral microbleeds, it increases the risk of coronary artery disease and ischemic stroke [5, 6]. There has been a presumed overlap in biology between intracranial hemorrhage or microbleed and white matter hyperintensities while the relationship between hyperlipidemia and leukoaraiosis severity is still controversial [8]. Some research even found that hypertriglyceridemia (hyper-TG) was associated with increased
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