RESUMEN
Objective To explore the possible correlation between uric acid levels and leukoaraiosis (LA). Methods This cross-sectional study enrolled patients who presented with some neurological discomfort (e.g. dizziness, headache, mild cognitive impairment). Potential demographic and clinical risk factors associated with LA, including sex, age, hypertension, diabetes mellitus, smoking, alcohol consumption, dyslipidaemia, plasma fibrinogen, D-dimer, uric acid, and homocysteine, were investigated using univariate and multivariate logistic regression analyses. Results A total of 268 patients were enrolled in the study and divided into the LA group ( n = 164) and the non-LA group ( n = 104). Compared with the non-LA group, uric acid was significantly higher in the LA group (mean ± SD: 356.49 ± 121.85 µmol/l versus 289.96 ± 102.98 µmol/l). Multivariate logistic regression analyses showed that uric acid was an independent risk factor for LA (odds ratio 1.285; 95% confidence interval 1.062, 1.556). Conclusion Hyperuricaemia was an independent risk factor for leukoaraiosis in Chinese patients.
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Hiperuricemia/diagnóstico , Leucoaraiosis/diagnóstico , Ácido Úrico/sangre , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/fisiopatología , Pueblo Asiatico , Disfunción Cognitiva/fisiopatología , Estudios Transversales , Diabetes Mellitus/fisiopatología , Mareo/fisiopatología , Dislipidemias/fisiopatología , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Fibrinógeno/metabolismo , Cefalea/fisiopatología , Homocisteína/sangre , Humanos , Hipertensión/fisiopatología , Hiperuricemia/sangre , Hiperuricemia/complicaciones , Hiperuricemia/etnología , Leucoaraiosis/sangre , Leucoaraiosis/complicaciones , Leucoaraiosis/etnología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Factores de Riesgo , Fumar/fisiopatologíaRESUMEN
AIM: Leukoaraiosis and high intraocular pressure are strongly associated with cardiovascular disease, vascular angiopathy, and geriatric syndrome. Until now, little is known about the relationship between intraocular pressure and leukoaraiosis in its preclinical stage. The aim of this study was to evaluate the association between intraocular pressure and leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia. METHODS: We examined the relationship of intraocular pressure with leukoaraiosis at a preclinical stage in 753 Korean adults (474 men, 279 women; mean age 57.8 ± 6.6 years). A multiple logistic regression analysis was performed in order to determine whether intraocular pressure is an independent determinant for leukoaraiosis. RESULTS: The overall prevalence of leukoaraiosis was 7.3%. Mean ocular pressure (±SD) was significantly higher in the leukoaraiosis group than the control group (14.3 ± 2.9 and 13.5 ± 2.9, respectively; P=0.028). In multiple logistic regression analysis, the odds ratio for leukoaraiosis was 1.18 (95% confidence interval: 1.06-1.31) for each 1 mm Hg increase in intraocular pressure. CONCLUSION: Intraocular pressure was found to be independently and positively associated with leukoaraiosis. This finding indicates that higher intraocular pressure may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting.
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Presión Intraocular/fisiología , Leucoaraiosis/fisiopatología , Anciano , Pueblo Asiatico/etnología , Demencia/fisiopatología , Femenino , Glaucoma/fisiopatología , Humanos , Corea (Geográfico)/epidemiología , Leucoaraiosis/diagnóstico , Leucoaraiosis/etnología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Estudios Retrospectivos , Tonometría OcularRESUMEN
OBJECTIVES: Leukoaraiosis is associated with cerebrovascular microangiopathy. Increasing evidence suggests that bilirubin is a potent cytoprotectant in the development of cardiovascular diseases. This study aimed to determine whether total bilirubin is related to leukoaraiosis. METHODS: We examined the relationship of total bilirubin with leukoaraiosis in 1005 Korean adults. The odds ratios for leukoaraiosis were calculated using multivariate logistic regression across serum total bilirubin tertiles. RESULTS: In comparison with the subjects in the reference group (total bilirubin: 15-26 µmol/L), the odds ratio (95% CI) for leukoaraiosis in the 3rd tertile (total bilirubin ≤10 µmol/L) was 5.50 (1.24-24.40) in women after adjusting for confounding variables. However, this inverse association between serum total bilirubin and the prevalence of leukoaraiosis was not found in men after adjusting for the same co-variables. CONCLUSION: Total bilirubin level was inversely associated with leukoaraiosis regardless of classical cardiovascular risk factors in Korean women.
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Bilirrubina/sangre , Leucoaraiosis/sangre , Angiografía Cerebral , Estudios Transversales , Femenino , Hospitales Urbanos , Humanos , Leucoaraiosis/epidemiología , Leucoaraiosis/etnología , Angiografía por Resonancia Magnética , Masculino , Registros Médicos , Persona de Mediana Edad , Prevalencia , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Caracteres SexualesRESUMEN
BACKGROUND AND PURPOSE: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. METHODS: Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. RESULTS: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm(3), P<0.0001) and whites (2.6 cm(3), P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95% CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only. CONCLUSIONS: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.
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Aterosclerosis/etnología , Población Negra/etnología , Presión Sanguínea , Leucoaraiosis/etnología , Fibras Nerviosas Mielínicas/patología , Características de la Residencia , Población Blanca/etnología , Anciano , Aterosclerosis/patología , Presión Sanguínea/fisiología , Estudios de Cohortes , Progresión de la Enfermedad , Etnicidad , Femenino , Humanos , Hipertensión/etnología , Hipertensión/patología , Leucoaraiosis/patología , Imagen por Resonancia Magnética , Masculino , Estudios Prospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Several studies have suggested that the specific stroke subtype may influence the presence of leukoaraiosis in patients with ischemic stroke. We investigated the association between stroke subtype and leukoaraiosis in Korean patients with ischemic stroke by MRI. METHODS: There were 594 patients included in this study that were classified as large artery disease, lacune and cardioembolic stroke. For large-artery disease, the analysis focused on the intracranial or extracranial location of the stenosis, and the multiplicity of the stenotic lesions. Leukoaraiosis grading was performed according to the Atherosclerosis Risk in Communities Study. RESULTS: There was a significant association between leukoaraiosis and the stroke subtypes; the large-artery-disease group had a higher prevalence of leukoaraiosis than did the other groups (55.4% in the large-artery-disease group, 30.3% in the lacunar group and 14.3% in the cardioembolic group, P = 0.016 by chi-square test). On the multivariate linear regression analysis, age, the presence of hypertension, previous stroke and stroke subtype were independently associated with the presence of leukoaraiosis. In the sub analysis of the large-artery-disease group, the leukoaraiosis had a tendency to be more prevalent in the mixed and intracranial stenosis group than did the extracranial stenosis group (45.5% in the mixed group, 40.3% in the intracranial group and 26.9% in the extracranial group, P = 0.08 by chi-square test). CONCLUSION: The association of leukoaraiosis with large-artery disease in this study might be due to the relatively high prevalence of intracranial occlusive lesions in Korean stroke patients compared to other ethnic groups.