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<0.01) and significantly higher proportion of male sex, hypertension, diabetes mellitus, prior stroke, and coronary heart disease(CHD), and fasting blood glucose(FBG)(all P values<0.05). The differences between patients with DWML and without DWML were similar to those with and without PVWML, except for levels of FBG (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.
陶永,周华东,王羚入,王敏,尹泽钢. 中老年人血脂水平与脑白质病变发生的相关性[J]. 中华解剖与临床杂志, 2016, 21(5): 407-412.
Tao Yong, Zhou Huadong, Wang Lingru, Wang Min, Yin Zegang.. The association of serum lipids with the presence of white matter lesions in middle-aged and elderly subjects. Chinese Journal of Anatomy and Clinics, 2016, 21(5): 407-412.
Sun J, Yu X, Jiaerken Y, et al. The relationship between microvasculature in white matter hyperintensities and cognitive function[J]. Brain Imaging Behav, 2016. DOI:10.1007/s11682-016-9531-8
[2]
Abraham HM, Wolfson L, Moscufo N, et al. Cardiovascular risk factors and small vessel disease of the brain: blood pressure, white matter lesions, and functional decline in older persons[J]. J Cereb Blood Flow Metab, 2016, 36(1): 132-142. DOI:10.1038/jcbfm.2015.121
[3]
Reina SA, Llabre MM, Allison MA, et al. HDL cholesterol and stroke risk: the multi-ethnic study of atherosclerosis[J]. Atherosclerosis, 2015, 243(1): 314-319. DOI:10.1016/j.atherosclerosis.2015.09.031
[4]
Meilhac O. High-density lipoproteins in stroke[J]. Handb Exp Pharmacol, 2015, 224: 509-526. DOI:10.1007/978-3-319-09665-0_16
[5]
Jickling G, Salam A, Mohammad A, et al. Circulating endothelial progenitor cells and age-related white matter changes[J]. Stroke, 2009, 40(10): 3191-3196. DOI:10.1161/strokeaha.109.554527
[6]
Jimenez-Conde J, Biffi A, Rahman R, et al. Hyperlipidemia and reduced white matter hyperintensity volume in patients with ischemic stroke[J]. Stroke, 2010, 41(3): 437-442. DOI:10.1161/strokeaha.109.563502
[7]
Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer′s dementia and normal aging[J]. AJR Am J Roentgenol, 1987, 149(2): 351-356. DOI:10.2214/ajr.149.2.351
[8]
Maggi P, Macri SM, Gaitán MI, et al. The formation of inflammatory demyelinated lesions in cerebral white matter[J]. Ann Neurol, 2014, 76(4): 594-608. DOI:10.1002/ana.24242
[9]
Yadav BK, Oh SY, Kim NK, et al. Association of rs2075575 and rs9951307 polymorphisms of AQP-4 gene with leukoaraiosis[J]. J Stroke Cerebrovasc Dis, 2014, 23(5): 1199-1206. DOI:10.1016/j.jstrokecerebrovasdis.2013.10.017
[10]
Tamura Y, Araki A. Diabetes mellitus and white matter hyperintensity[J]. Geriatr Gerontol Int, 2015, 15 Suppl 1:34-42. DOI: 10.1111/ggi.12666
[11]
Watts A, Honea RA, Billinger SA, et al. A combined measure of vascular risk for white matter lesions[J]. J Alzheimers Dis, 2015, 45(1): 187-193. DOI:10.3233/JAD-142085
Mi T, Sun S, Zhang G, et al. Relationship between dyslipidemia and carotid plaques in a high-stroke-risk population in Shandong Province, China[J]. Brain Behav, 2016, 6(6): e00473. DOI:10.1002/brb3.473
[14]
Murray AD, Staff RT, Shenkin SD, et al. Brain white matter hyperintensities: relative importance of vascular risk factors in nondemented elderly people[J]. Radiology, 2005, 237(1): 251-257. DOI:10.1148/radiol.2371041496
[15]
Breteler MM, van Swieten JC, Bots ML, et al. Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the rotterdam study[J]. Neurology, 1994, 44(7): 1246-1252. DOI:10.1212/wnl.44.7.1246
[16]
Jagust W, Harvey D, Mungas D, et al. Central obesity and the aging brain[J]. Arch Neurol, 2005, 62(10): 1545-1548. DOI:10.1001/archneur.62.10.1545
[17]
Saji N, Shimizu H, Kawarai T, et al. Increased brachial-ankle pulse wave velocity is independently associated with white matter hyperintensities[J]. Neuroepidemiology, 2011, 36(4): 252-257. DOI:10.1159/000328260
[18]
Crisby M, Bronge L, Wahlund LO. Low levels of high density lipoprotein increase the severity of cerebral white matter changes: implications for prevention and treatment of cerebrovascular diseases[J]. Curr Alzheimer Res, 2010, 7(6): 534-539. DOI:10.2174/156720510792231694
[19]
Walldius G, Jungner I. The apo B/apo A-Ⅰ ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy-a review of the evidence[J]. J Intern Med, 2006, 259(5): 493-519. DOI:10.1111/j.1365-2796.2006.01643.x
[20]
Holme I, Aastveit AH, Hammar N, et al. Relationships between lipoprotein components and risk of ischaemic and haemorrhagic stroke in the Apolipoprotein MOrtality RISk study (AMORIS)[J]. J Intern Med, 2009, 265(2): 275-287. DOI:10.1111/j.1365-2796.2008.02016.x
[21]
Schmidt R, Fazekas F, Hayn M, et al. Risk factors for microangiopathy-related cerebral damage in the Austrian stroke prevention study[J]. J Neurol Sci, 1997, 152(1): 15-21
[22]
Park JH, Hong KS, Lee J, et al. Deep subcortical infarct burden in relation to apolipoprotein B/AI ratio in patients with intracranial atherosclerotic stenosis[J]. Eur J Neurol, 2013, 20(4): 671-680. DOI:10.1111/ene.12021
[23]
Saczynski JS, White L, Peila RL, et al. The relation between apolipoprotein A-I and dementia: the Honolulu-Asia aging study[J]. Am J Epidemiol, 2007, 165(9): 985-992. DOI:10.1093/aje/kwm027.
2016, Vol. 21 
