Cerebral White Matter Hyperintensity as a Healthcare Quotient
Cerebral White Matter Hyperintensity as a Healthcare Quotient
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DOI：
10.3390/jcm8111823
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发表时间：
2019-11-01
影响因子：
3.9
通讯作者：
Sasaki, Makoto
中科院分区：
文献类型：
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作者：
Park, Kaechang;Nemoto, Kiyotaka;Sasaki, Makoto
为了更好地了解脑白色高信号（WMH）的危险因素和最佳治疗策略，我们检查了大量有和无各种血管危险因素（VRF）或血管危险状况（VRC）的成年人，如高血压（HT）、糖尿病（DM）和血脂异常（DLP），包括合并症。我们评估了两组没有中风或痴呆病史的参与者，他们使用磁共振成像（MRI）进行了脑部检查：5541名参与者（2760名男性，2781名女性）没有VRC，1969名参与者（1169名男性，800名女性）接受了VRC和合并症的药物治疗。为了进行数据分析，我们根据WMH体积的百分位数排名构建了WMH-脑健康商数（WMH-BHQ）。该度量与WMH成反比。对5541例无VRC的受试者进行多元线性回归分析，发现年龄、收缩压（SBP）、Brinkman指数（BI）和女性是降低WMH-BHQ的重要因素，而体重指数（BMI）、男性、空腹血糖和甘油三酯水平是增加因素。Kruskal-Wallis检验和Dunn检验显示，WMH-BHQ分别随BMI或SBP以及BI分级显著增加或降低。至于空腹血糖受损和脂质代谢异常的影响，几乎没有显着的关系。对于1969名患有HT、DM和DLP及其合并症的受试者，我们发现DLP在增加某些合并症的WMH-BHQ方面发挥了重要作用，而HT和DM单独存在则倾向于降低WMH-BHQ。脑WMH可用作定量评估VRF和VRC及其合并症的健康商数。
To better understand the risk factors and optimal therapeutic strategies of cerebral white matter hyperintensity (WMH), we examined a large population of adults with and without various vascular risk factors (VRFs) or vascular risk conditions (VRCs), such as hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP), including the comorbidities. We assessed two participant groups having no medical history of stroke or dementia that underwent brain checkup using magnetic resonance imaging (MRI): 5541 participants (2760 men, 2781 women) without VRCs and 1969 participants (1169 men, 800 women) who had received drug treatments for VRCs and the combination of comorbidities. For data analysis, we constructed WMH-brain healthcare quotient (WMH-BHQ) based on the percentile rank of WMH volume. This metric has an inverse relation to WMH. Multiple linear regression analysis of 5541 participants without VRCs revealed that age, systolic blood pressure (SBP), Brinkman index (BI), and female sex were significant factors lowering WMH-BHQ, whereas body mass index (BMI), male sex, fasting blood sugar, and triglyceride levels were increasing factors. The Kruskal-Wallis test and Dunn tests showed that WMH-BHQs significantly increased or decreased with BMI or SBP and with BI classification, respectively. Regarding the impact of impaired fasting glucose and abnormal lipid metabolism, there were almost no significant relationships. For 1969 participants who had HT, DM, and DLP, as well as their comorbidities, we found that DLP played a substantial role in increasing WMH-BHQ for some comorbidities, whereas the presence of HT and DM alone tended to decrease it. Cerebral WMH can be used as a healthcare quotient for quantitatively evaluating VRFs and VRCs and their comorbidities.