Ryu Wi-Sun, Lee Seung-Hoon, Kim Chi Kyung, Kim Beom Joon, Kwon Hyung-Min, Yoon Byung-Woo
Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Department of Neurology, Seoul National University Hospital, 28 Yongon-dong, Jongno-gu, Seoul 110-744, Republic of Korea.
Atherosclerosis. 2014 Feb;232(2):313-8. doi: 10.1016/j.atherosclerosis.2013.11.047. Epub 2013 Dec 3.
Vascular calcification is related with cerebral small vessel disease. We investigated whether alkaline phosphatase (ALP), a marker of vascular calcificiation, is related to cerebral small vessel disease.
We included 1082 neurologically healthy subjects who underwent brain magnetic resonance image for a routine health checkup. ALP levels were divided into quartiles. We used quantile regression and logistic regression to evaluate the associations of ALP with white matter hyperintensities (WMH), cerebral infarct and cerebral microbleeds.
Subjects with higher ALP were more likely to have a large WMH volume. The adjusted difference of WMH volume between the highest and the lowest quartiles was 0.27 mL (95% confidence interval [CI]; 0.22-0.31 mL). In addition, cerebral infarct was more prevalent in subjects with higher ALP. Compared to the lowest quartile, adjusted odds ratios of having cerebral infarct for the highest quartile was 2.60 (95% CI, 1.10-6.10). No association was found between ALP and cerebral microbleeds. In addition, we found a conjoint effect of ALP and C-reactive protein(CRP) on cerebral small vessel disease. Compared with subjects with low ALP (≤63 IU/L) and low CRP (≤0.5 mg/dl), those with high ALP (>63 IU/L) and high CRP (>0.5 mg/dl) had larger WMH volume (adjusted difference 0.39 mL; 95% CI 0.37-0.42 mL) and a 3-fold (adjusted OR. 3.37; 95% CI, 1.61-7.03) risk of cerebral infarct.
We found that higher serum levels of ALP are independently associated with WMH and cerebral infarct, but not with cerebral microbleeds.
血管钙化与脑小血管病相关。我们研究了作为血管钙化标志物的碱性磷酸酶（ALP）是否与脑小血管病有关。
我们纳入了1082名接受脑部磁共振成像进行常规健康检查的神经功能正常的受试者。ALP水平被分为四分位数。我们使用分位数回归和逻辑回归来评估ALP与白质高信号（WMH）、脑梗死和脑微出血之间的关联。
ALP水平较高的受试者更有可能有较大的WMH体积。最高和最低四分位数之间WMH体积的校正差异为0.27 mL（95%置信区间[CI]；0.22 - 0.31 mL）。此外，脑梗死在ALP水平较高的受试者中更为普遍。与最低四分位数相比，最高四分位数发生脑梗死的校正比值比为2.60（95% CI，1.10 - 6.10）。未发现ALP与脑微出血之间存在关联。此外，我们发现ALP和C反应蛋白（CRP）对脑小血管病有联合作用。与低ALP（≤63 IU/L）和低CRP（≤0.5 mg/dl）的受试者相比，高ALP（>63 IU/L）和高CRP（>0.5 mg/dl）的受试者有更大的WMH体积（校正差异0.39 mL；95% CI 0.37 - 0.42 mL）和发生脑梗死的风险增加3倍（校正OR. 3.37；95% CI，1.61 - 7.03）。
我们发现较高的血清ALP水平与WMH和脑梗死独立相关，但与脑微出血无关。
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