Szum-Jakubowska Aleksandra, Chlabicz Malgorzata, Dubatówka Marlena, Stachurska Zofia, Jamiolkowski Jacek, Teumer Alexander, Wittfeld Katharina, Hładuński Marcin, Kubas Bożena, Pawlak Mikolaj A, Kamiński Karol A
Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
Doctoral School, Medical University of Bialystok, Białystok, Poland
Pol Arch Intern Med. 2024 Sep 27;134(9). doi: 10.20452/pamw.16825. Epub 2024 Aug 12.
White matter hyperintensities, present in patients and asymptomatic individuals, have been previously shown to be associated with atherosclerosis risk factors, such as high blood pressure, hypercholesterolemia, smoking, and diabetes.
Our aim was to examine the associations between the volume of white matter hyperintensities and cardiovascular risk factors in the general, apparently healthy population.
The analysis includes 735 participants (aged 20 to 79 years) without neurological or severe cardiac diseases. The participants underwent detailed clinical examination, including medical history, biochemical analyses, carotid arteries ultrasound, and brain magnetic resonance imaging, followed by white matter hyperintensities segmentation using the FreeSurfer tool. The participants were divided into 3 cardiovascular risk (CVR) categories based on the 2021 European Society of Cardiology guidelines.
The median volume of white matter hyperintensities was 95.2 mm3 (interquartile range, 2.1-482 mm3). Multivariable analysis revealed positive independent association between the volume of white matter hyperintensities and CVR categories, glycated hemoglobin concentration, presence of carotid plaques, and central systolic blood pressure. An analysis including individuals without hypertension or diabetes revealed mean intima‑media thickness and high or very high cardiovascular risk class as independent predictors of white matter hyperintensities percentile.
The cardiovascular risk class, presence of carotid plaques, increased intima‑media complex thickness, and diabetes are the main risk factors for white matter hyperintensities in apparently healthy adults. People without hypertension or diabetes but with higher CVR are also at a risk for developing white matter hyperintensities, which emphasizes the importance of CVR assessment for prediction of neurodegenerative changes.
白质高信号出现在患者和无症状个体中，先前已被证明与动脉粥样硬化风险因素有关，如高血压、高胆固醇血症、吸烟和糖尿病。
我们的目的是研究在一般的、看似健康的人群中，白质高信号体积与心血管危险因素之间的关联。
分析纳入了735名（年龄在20至79岁之间）无神经系统疾病或严重心脏疾病的参与者。参与者接受了详细的临床检查，包括病史、生化分析、颈动脉超声和脑磁共振成像，随后使用FreeSurfer工具对白质高信号进行分割。根据2021年欧洲心脏病学会指南，将参与者分为3个心血管风险（CVR）类别。
白质高信号的中位数体积为95.2立方毫米（四分位间距，2.1 - 482立方毫米）。多变量分析显示，白质高信号体积与CVR类别、糖化血红蛋白浓度、颈动脉斑块的存在以及中心收缩压之间存在正独立关联。一项纳入无高血压或糖尿病个体的分析显示，平均内膜中层厚度以及高或非常高的心血管风险类别是白质高信号百分位数的独立预测因素。
心血管风险类别、颈动脉斑块的存在、内膜中层复合体厚度增加以及糖尿病是看似健康的成年人白质高信号的主要风险因素。无高血压或糖尿病但CVR较高的人也有发生白质高信号的风险，这强调了CVR评估对预测神经退行性变化的重要性。
