The Medical School of Anhui University of Science and Technology, Huainan, Anhui Province, People's Republic of China.
Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan, Huainan, Anhui Province, People's Republic of China.
Lipids Health Dis. 2024 Oct 14;23(1):333. doi: 10.1186/s12944-024-02318-3.
Lipids are associated with atherosclerosis, and novel lipid indices have been recently identified to be closely linked to cardiovascular diseases. This study explored the association between four novel lipid indices and the white matter hyperintensities (WMHs) in patients diagnosed with cerebral small vessel disease (CSVD).
Between January 2023 and February 2024, 219 patients were recruited, including 165 patients with CSVD WMHs and 54 healthy controls. Based on WMHs severity, patients with CSVD were categorised into mild and moderate-to-severe cohorts using the Fazekas rating scale. The plasma levels of four novel lipid indices (low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio [LDL-C/HDL-C], triglyceride/high-density lipoprotein cholesterol ratio [TG/HDL-C], total cholesterol/high-density lipoprotein cholesterol ratio [TC/HDL-C], and non-high-density lipoprotein cholesterol [Non-HDL-C]), were rigorously monitored in the enrolled patients.
A total of 165 patients with CSVD WMHs were enrolled, including 94 with mild WMHs and 71 with moderate-to-severe WMHs. Multivariable logistic regression analysis revealed that LDL-C/HDL-C, TG/HDL-C, TC/HDL-C, and Non-HDL-C levels were significantly associated with WMHs (all P ≤ 0.001). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of plasma lipid levels for WMHs in patients with CSVD. The novel lipid indicators outperformed traditional lipid indicators in assessing the diagnostic capability of WMHs. The combined index of the four blood lipid indices had an optimal cutoff point (OCP) of 0.489, with 88.3% sensitivity and 60.6% specificity. The area under the curve (AUC) is 0.800 (95% confidence interval [CI], 0.731-0.869; P < 0.001). Compared with males (OR = 1.126, 95% CI = 0.779-1.628), females (OR = 2.484, 95% CI = 1.398-4.414; P for interaction = 0.023) had a higher risk of developing WMHs.
This study demonstrates a significant association between four novel lipid indices and the cerebral WMHs in CSVD, highlighting the potential of these markers as novel plasma biomarkers and predictive indicators for assessing CSVD progression and guiding clinical management.
脂质与动脉粥样硬化有关，最近发现了一些新的脂质指标与心血管疾病密切相关。本研究探讨了四种新型脂质指标与被诊断为脑小血管病（CSVD）患者的脑白质高信号（WMHs）之间的关系。
2023 年 1 月至 2024 年 2 月期间，共招募了 219 名患者，包括 165 名 CSVD WMH 患者和 54 名健康对照者。根据 WMHs 严重程度，采用 Fazekas 评分量表将 CSVD 患者分为轻度和中重度两组。在纳入的患者中，严格监测了四种新型脂质指标（低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值[LDL-C/HDL-C]、甘油三酯/高密度脂蛋白胆固醇比值[TG/HDL-C]、总胆固醇/高密度脂蛋白胆固醇比值[TC/HDL-C]和非高密度脂蛋白胆固醇[Non-HDL-C]）的血浆水平。
共纳入 165 名 CSVD WMH 患者，其中 94 名患者为轻度 WMHs，71 名患者为中重度 WMHs。多变量逻辑回归分析显示，LDL-C/HDL-C、TG/HDL-C、TC/HDL-C 和 Non-HDL-C 水平与 WMHs 显著相关（均 P≤0.001）。进行了受试者工作特征（ROC）曲线分析，以评估血浆脂质水平对 CSVD 患者 WMHs 的诊断性能。新型脂质指标在评估 WMHs 的诊断能力方面优于传统脂质指标。四项血脂指标联合指标的最佳截断点（OCP）为 0.489，具有 88.3%的敏感性和 60.6%的特异性。曲线下面积（AUC）为 0.800（95%置信区间[CI]，0.731-0.869；P<0.001）。与男性（比值比[OR] = 1.126，95%CI = 0.779-1.628）相比，女性（OR = 2.484，95%CI = 1.398-4.414；P 交互值=0.023）发生 WMHs 的风险更高。
本研究表明，四种新型脂质指标与 CSVD 患者的脑内 WMHs 之间存在显著关联，这表明这些标志物可能作为新型血浆生物标志物和预测指标，用于评估 CSVD 的进展并指导临床管理。
