Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Cerebrovasc Dis. 2023;52(4):417-426. doi: 10.1159/000527019. Epub 2022 Nov 8.
Cerebral microbleeds (CMBs) detected on susceptibility-weighted imaging (SWI) are associated with cerebral small vessel disease. Chronic kidney disease and microalbuminuria have been associated with the presence of CMBs in stroke patients. Urinary immunoglobulin G (IgG) is measured to document glomerular injury; however, the relationship between urinary IgG and CMBs is unknown.
We retrospectively enrolled consecutive patients who had been admitted with transient ischemic attack (TIA) or ischemic stroke and identified those who had undergone SWI and a spot urine test. The location of CMBs was classified on magnetic resonance imaging as strictly lobar, deep/infratentorial (D/I), or mixed areas. We analyzed the association between urinary IgG and the presence and location of CMBs.
We included 298 patients (86 female, median age 70 years, median eGFR 65.8 mL/min/1.73 m2). Positive urinary IgG and CMB results were found in 58 (19%) and 160 patients (54%), respectively. Urinary IgG positivity was significantly associated with CMBs compared with non-CMBs (28% vs. 9%, p < 0.001), and with D/I or mixed CMBs compared with non-D/I or mixed CMBs (34% vs. 10%, p < 0.001). Multivariate analysis revealed that urinary IgG and hypertension positivity were strongly associated with D/I or mixed CMBs (OR 3.479, 95% CI: 1.776-6.818, p < 0.001; OR 3.415, 95% CI: 1.863-6.258, p < 0.001).
Urinary IgG was associated with the prevalence of D/I or mixed location CMBs in TIA or ischemic stroke patients. Our findings provide new insights into the association between urinary IgG and the distribution of CMBs.
在磁敏感加权成像 (SWI) 上检测到的脑微出血 (CMB) 与脑小血管疾病有关。慢性肾脏病和微量白蛋白尿与中风患者 CMB 的存在有关。尿免疫球蛋白 G (IgG) 用于记录肾小球损伤；然而，尿 IgG 与 CMB 之间的关系尚不清楚。
我们回顾性纳入了因短暂性脑缺血发作 (TIA) 或缺血性卒中入院的连续患者，并确定了那些接受了 SWI 和尿液检测的患者。CMB 的位置在磁共振成像上分为严格的叶性、深部/幕下 (D/I) 或混合区域。我们分析了尿 IgG 与 CMB 存在和位置之间的关系。
我们纳入了 298 名患者（86 名女性，中位年龄 70 岁，中位 eGFR 65.8 mL/min/1.73 m2）。58 名（19%）和 160 名患者（54%）分别检测到尿 IgG 阳性和 CMB 阳性。与非 CMB 相比，尿 IgG 阳性与 CMB 显著相关（28% vs. 9%，p<0.001），与 D/I 或混合 CMB 相比，与非 D/I 或混合 CMB 相比，尿 IgG 阳性与 CMB 显著相关（34% vs. 10%，p<0.001）。多变量分析显示，尿 IgG 和高血压阳性与 D/I 或混合 CMB 密切相关（OR 3.479，95%CI：1.776-6.818，p<0.001；OR 3.415，95%CI：1.863-6.258，p<0.001）。
尿 IgG 与 TIA 或缺血性卒中患者 D/I 或混合部位 CMB 的发生率相关。我们的发现提供了尿 IgG 与 CMB 分布之间关联的新见解。
