Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
CARIM - School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Geroscience. 2022 Feb;44(1):147-157. doi: 10.1007/s11357-021-00493-0. Epub 2021 Nov 23.
Cerebral small vessel disease (cSVD) is a late consequence of cerebral microvascular dysfunction (MVD). MVD is hard to measure in the brain due to its limited accessibility. Extracerebral MVD (eMVD) measures can give insights in the etiology of cerebral MVD, as MVD may be a systemic process. We aim to investigate whether a compound score consisting of several eMVD measures is associated with structural cSVD MRI markers.
Cross-sectional data of the population-based Maastricht Study was used (n = 1872, mean age 59 ± 8 years, 49% women). Measures of eMVD included flicker light-induced retinal arteriolar and venular dilation response (retina), albuminuria and glomerular filtration rate (kidney), heat-induced skin hyperemia (skin), and plasma biomarkers of endothelial dysfunction (sICAM-1, sVCAM-1, sE-selectin, and von Willebrand factor). These measures were standardized into z scores and summarized into a compound score. Linear and logistic regression analyses were used to investigate the associations between the compound score and white matter hyperintensity (WMH) volume, and the presence of lacunes and microbleeds, as measured by brain MRI.
The eMVD compound score was associated with WMH volume independent of age, sex, and cardiovascular risk factors (St β 0.057 [95% CI 0.010-0.081], p value 0.01), but not with the presence of lacunes (OR 1.011 [95% CI 0.803-1.273], p value 0.92) or microbleeds (OR 1.055 [95% CI 0.896-1.242], p value 0.52).
A compound score of eMVD is associated with WMH volume. Further research is needed to expand the knowledge about the role of systemic MVD in the pathophysiology of cSVD.
脑小血管病（cSVD）是脑微血管功能障碍（MVD）的晚期后果。由于脑内 MVD 的可及性有限，因此很难对其进行测量。颅外 MVD（eMVD）的测量可以深入了解脑 MVD 的病因，因为 MVD 可能是一个系统性过程。我们旨在研究由几种 eMVD 测量值组成的复合评分是否与结构性 cSVD MRI 标志物相关。
本研究使用了基于人群的马斯特里赫特研究的横断面数据（n=1872，平均年龄 59±8 岁，49%为女性）。eMVD 测量包括闪烁光诱导视网膜动、静脉扩张反应（视网膜）、白蛋白尿和肾小球滤过率（肾脏）、热诱导皮肤充血（皮肤）以及内皮功能障碍的血浆生物标志物（sICAM-1、sVCAM-1、sE-选择素和血管性血友病因子）。这些测量值被标准化为 z 分数，并总结为一个复合评分。使用线性和逻辑回归分析来研究复合评分与脑 MRI 测量的脑白质高信号（WMH）体积以及腔隙和微出血的存在之间的关联。
eMVD 复合评分与 WMH 体积相关，独立于年龄、性别和心血管危险因素（Stβ0.057[95%CI 0.010-0.081]，p 值=0.01），但与腔隙的存在无关（OR 1.011[95%CI 0.803-1.273]，p 值=0.92）或微出血（OR 1.055[95%CI 0.896-1.242]，p 值=0.52）。
eMVD 的复合评分与 WMH 体积相关。需要进一步研究以扩展关于系统性 MVD 在 cSVD 病理生理学中作用的知识。
