The association of serum lipids with the presence of white matter lesions in middle-aged and elderly subjects

Abstract

Objective To investigate the association of serum lipids with the presence of white matter lesions (WML) in middle-aged and elderly subjects. Methods From June 2012 to June 2013, 1 282 patients aged 50 years and older in the neurology department of Daping Hospital of Third Military Medical University were retrospectively enrolled. There were 606 males and 676 females. The mean age of the study subjects was (65.9±7.9) years. All patients underwent MRI examination, fasting blood glucose and blood lipid analysis. In 1 282 patients, 781 patients were WML. According to the classification of WML, 678 patients of periventricular white matter lesions (PVWML) and 724 patients of deep white matter lesions (DWML). Multivariate logistic regression analyses were performed to examine the association of each lipid index with WML. Results Analysis of 1 282 patients showed that patients with PVWML were older(P 0.05). The distribution of serum total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), and apolipoprotein A-Ⅰ(Apo A-Ⅰ) levels were significantly different between four grades of PVWML and DWML(all P values<0.05). The distribution of serum low-density lipoprotein cholesterol(LDL-C) and apolipoprotein B(Apo B) levels were significantly different between four grades of PVWML (all P values<0.05). After adjustment for age, sex, prior stroke, coronary heart disease, hypertension, and diabetes, plasma levels of HDL-C and Apo A-Ⅰ were closely related to the risk of PVWML and DWML. Conclusions Decreased serum levels of HDL-C and Apo A-Ⅰ were independent risk factors associated with PVWML and DWML in middle-aged and elderly subjects. Key words: Dyslipidemias; Cerebral white matter lesions; High-density lipoprotein cholesterol; Apolipoprotein A-Ⅰ