Cerebral small vessel disease and C-reactive protein: results of a cross-sectional study in community-based Japanese elderly.
OBJECTIVE
Inflammatory processes are involved in the pathogenesis of atherosclerosis. Inflammation has been known as a risk factor for coronary heart disease, whereas inflammation as a risk for cerebrovascular disease is less well established. Whether inflammatory processes, excluded from their involvement in large-vessel disease, are implicated in the pathogenesis of cerebral small vessel disease remains unclear. We assessed whether higher C-reactive protein (CRP) levels were associated with an increased number of lacunar infarcts or severity of white matter lesions.


RESULTS
In a community-based group of Japanese elderly (n=689), CRP concentrations were measured using a highly sensitive assay. All participants underwent magnetic resonance imaging (MRI), and cerebral small vessel disease-related lesions (lacunar infarcts and white matter hyperintensity) were subsequently evaluated. Furthermore, carotid atherosclerosis was also assessed with ultrasonography. As the grades of white matter hyperintensity and the numbers of lacunes were considered small vessel disease-related lesions, we evaluated the relationships between CRP levels and small vessel disease-related brain lesions. Interestingly, the median CRP concentration of our participants was remarkably lower, being approximately one third or one quarter of the value of Western populations. Subjects with higher CRP levels tended to have more small vessel disease-related lesions; however, these associations were not seen after adjustment for cardiovascular risk factors and carotid atherosclerosis.


CONCLUSIONS
The relationship between CRP levels and small vessel disease-related lesions was not apparent in the community-based Japanese elderly. The impact of inflammation in the pathogenesis of small vessel disease-related brain lesions seems to be weak among the Japanese elderly.
Wada
Manabu
M
Department of Neurology, Hematology, Metabolism, Endocrinology, and Diabetology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. mwada@yacht.ocn.ne.jp
Nagasawa
Hikaru
H
Kurita
Keiji
K
Koyama
Shingo
S
Arawaka
Shigeki
S
Kawanami
Toru
T
Tajima
Katsushi
K
Daimon
Makoto
M
Kato
Takeo
T
D000367:Age Factors; D000368:Aged; D044466:Asian People; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007249:Inflammation / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D044469:Racial Groups; D017585:Ultrasonography, Doppler, Transcranial
D015415:Biomarkers; D002097:C-Reactive Protein