title: Deep white matter hyperintensities, decreased serum low-density lipoprotein, and dilative large arteriopathy.
abstract: Deep white matter hyperintensities (DWMHs) seen on magnetic resonance imaging (MRI) are thought to reflect small-vessel diseases (SVDs) and may have a background that differs from that of stenotic large-vessel diseases. We assessed risk factors for DWMHs and investigated the association between DWMHs and dilative changes in the basilar artery (BA) on MRI in nonstroke patients. We reviewed clinical information and MRI findings for 149 outpatients aged 46-90 years, excluding those with a previous symptomatic cerebrovascular event. DWMHs were graded 0-3, and the maximal BA diameter and area were measured from the flow void on axial T2-weighted MRI to assess dilatation. We divided the patients into groups with and without DWMH grade 2 or 3, and compared clinical information and BA parameters in these groups. The two groups demonstrated significant differences in age, serum low-density lipoprotein (LDL) level, estimated glomerular filtration rate (eGFR), and BA parameters. An adjusted logistic regression analysis including BA diameter found that age (odds ratio [OR], 1.974 per 10 years; 95% confidence interval [CI], 1.030-1.112; P = .0006), LDL (OR, 0.811 per 10 mg/dL; 95% CI, 0.964-0.965; P = .0085), eGFR (OR, 0.835 per 10 mL/min/1.73 m(2); 95% CI, 0.967-0.998; P = .0229), and BA diameter (OR, 2.515 per 1 mm; 95% CI, 1.191-4.098; P = .0119) were independently associated with the presence of DWMHs. An analysis including the BA area yielded similar results. DWMHs are manifestations of SVDs and show a strong association with lower serum LDL level, lower eGFR, and BA dilatation.
authors.affiliation: Department of Neurology, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan. h_ichikawa0527@yahoo.co.jp
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ichikawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Mukai
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohno
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Itaya
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kawamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001488:Basilar Artery / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014715:Vertebrobasilar Insufficiency / Q000097:blood* / Q000473:pathology* / Q000503:physiopathology
chemical_list: D008077:Lipoproteins, LDL