Inserm U708, Neuroepidemiology, Paris, France.
Neurology. 2013 Feb 12;80(7):662-9. doi: 10.1212/WNL.0b013e318281ccc2. Epub 2013 Jan 23.
Our aim was to investigate the relationship of carotid structure and function with MRI markers of cerebral ischemic small-vessel disease.
The study comprised 1,800 participants (aged 72.5 ± 4.1 years, 59.4% women) from the 3C-Dijon Study, a population-based, prospective cohort study, who had undergone quantitative brain MRI and carotid ultrasound. We used multivariable logistic and linear regression adjusted for age, sex, and vascular risk factors.
Presence of carotid plaque and increasing carotid lumen diameter (but not common carotid artery intima-media thickness) were associated with higher prevalence of lacunar infarcts: odds ratio (OR) = 1.60 (95% confidence interval [CI]: 1.09-2.35), p = 0.02 and OR = 1.24 (95% CI: 1.02-1.50), p = 0.03 (by SD increase). Carotid plaque was also associated with large white matter hyperintensity volume (WMHV) (age-specific top quartile of WMHV distribution): OR = 1.32 (95% CI: 1.04-1.67), p = 0.02, independently of vascular risk factors. Increasing Young elastic modulus and higher circumferential wall stress, reflecting augmented carotid stiffness, were associated with increasing WMHV (effect estimate [β] ± standard error: 0.0003 ± 0.0001, p = 0.024; β ± standard error: 0.005 ± 0.002, p = 0.008). Large WMHV was also associated with increasing Young elastic modulus (OR = 1.22 [95% CI: 1.04-1.42], p = 0.01) and with decreasing distensibility coefficient (OR = 0.83 [95% CI: 0.69-0.99], p = 0.04), independently of vascular risk factors. Associations of carotid lumen diameter with lacunar infarcts and of carotid stiffness markers with WMHV were independent of carotid plaque.
In addition to and independently of carotid plaque, increasing carotid lumen diameter and markers of carotid stiffness were associated with increasing prevalence of lacunar infarcts and increasing WMHV, respectively.
我们旨在研究颈动脉结构和功能与脑缺血小血管疾病的 MRI 标志物之间的关系。
这项研究纳入了来自 3C-Dijon 研究的 1800 名参与者（年龄 72.5±4.1 岁，59.4%为女性），这是一项基于人群的前瞻性队列研究，参与者接受了定量脑 MRI 和颈动脉超声检查。我们使用多变量逻辑回归和线性回归模型，对年龄、性别和血管危险因素进行了调整。
颈动脉斑块的存在和颈动脉管腔直径的增加（而不是颈总动脉内膜-中层厚度）与腔隙性梗死的发生率较高相关：比值比（OR）=1.60（95%置信区间[CI]：1.09-2.35），p=0.02 和 OR=1.24（95%CI：1.02-1.50），p=0.03（按 SD 增加）。颈动脉斑块也与较大的白质高信号体积（WMHV）（WMHV 分布的年龄特异性最高四分位数）相关：OR=1.32（95%CI：1.04-1.67），p=0.02，独立于血管危险因素。颈动脉弹性模量增加和周向壁应力增加，反映了颈动脉僵硬度增加，与 WMHV 增加相关（估计效应[β]±标准误差：0.0003±0.0001，p=0.024；β±标准误差：0.005±0.002，p=0.008）。较大的 WMHV 也与弹性模量增加（OR=1.22（95%CI：1.04-1.42），p=0.01）和可扩张性系数降低（OR=0.83（95%CI：0.69-0.99），p=0.04）相关，独立于血管危险因素。颈动脉管腔直径与腔隙性梗死的关系，以及颈动脉僵硬度标志物与 WMHV 的关系，均独立于颈动脉斑块。
除颈动脉斑块外，颈动脉管腔直径增加和颈动脉僵硬度标志物与腔隙性梗死的发生率增加和 WMHV 增加分别相关。
