Department of Family Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Republic of Korea; Yonsei University Graduate School of Medicine, Republic of Korea.
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Exp Gerontol. 2019 Oct 1;125:110682. doi: 10.1016/j.exger.2019.110682. Epub 2019 Aug 6.
Leukoaraiosis refers to lesions of high signal intensities in periventricular and subcortical white matter, which result from chronic microvascular ischemic damage of the brain. Emerging evidence suggests that serum carcinoembryonic antigen (CEA) is elevated in cardiometabolic diseases, which are closely related with microangiopathy. Thus, we hypothesized that serum CEA levels could be associated with leukoaraiosis and aimed to examine this association among middle-aged and older adults.
This cross-sectional study included 2164 Korean adults aged ≥ 45 years who underwent a health examination program at a single hospital between 2010 and 2015. Serum CEA levels were quantified by chemiluminescence immunoassay and categorized as quartiles: Q1: ≤ 1.1, Q2: 1.2-1.6, Q2: 1.7-2.4, and Q4: ≥ 2.5 μg/L. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for leukoaraiosis based on brain MRI scans were calculated across serum CEA quartiles using multiple logistic regression analysis after adjusting for age, sex, body mass index, smoking status, fasting plasma glucose, triglyceride, HDL-cholesterol, hypertension, type 2 diabetes, and leukocyte count.
The overall prevalence of leukoaraiosis was 5.4% and increased with serum CEA quartiles: 3.3% for Q1, 5.0% for Q2, 5.8% for Q3, and 7.6% for Q4 (P < 0.001). The OR (95% CI) of the highest CEA quartile, compared to the lowest quartile, for leukoaraiosis was 2.164 (1.169-4.006) after adjusting for confounding variables.
Serum CEA levels were positively and independently associated with leukoaraiosis. Our findings indicate that serum CEA level might be useful additional measure in assessing leukoaraiosis in clinical settings.
脑白质疏松症是指脑室周围和皮质下白质的高信号强度病变，是由于脑的慢性微血管缺血性损伤所致。新出现的证据表明，血清癌胚抗原（CEA）在代谢性心血管疾病中升高，而这些疾病与微血管病变密切相关。因此，我们假设血清 CEA 水平可能与脑白质疏松症有关，并旨在检查中年及以上成年人中这种相关性。
本横断面研究纳入了 2164 名年龄≥45 岁的韩国成年人，他们于 2010 年至 2015 年在一家医院进行了健康体检计划。通过化学发光免疫分析法定量检测血清 CEA 水平，并将其分为四个四分位数：Q1：≤1.1μg/L、Q2：1.2-1.6μg/L、Q3：1.7-2.4μg/L 和 Q4：≥2.5μg/L。使用多因素逻辑回归分析，在校正年龄、性别、体重指数、吸烟状况、空腹血糖、甘油三酯、高密度脂蛋白胆固醇、高血压、2 型糖尿病和白细胞计数后，计算了基于脑 MRI 扫描的脑白质疏松症的血清 CEA 四分位数的比值比（OR）和 95%置信区间（95%CI）。
脑白质疏松症的总患病率为 5.4%，并随血清 CEA 四分位数的增加而增加：Q1 为 3.3%、Q2 为 5.0%、Q3 为 5.8%和 Q4 为 7.6%（P<0.001）。在校正混杂因素后，与最低四分位数相比，CEA 最高四分位数的脑白质疏松症的 OR（95%CI）为 2.164（1.169-4.006）。
血清 CEA 水平与脑白质疏松症呈正相关且独立相关。我们的研究结果表明，血清 CEA 水平可能是评估临床脑白质疏松症的有用附加指标。
