title: Plasma fibrinogen, global cognitive function, and cerebral small vessel disease: results of a cross-sectional study in community-dwelling Japanese elderly.
abstract: OBJECTIVE
  Recent studies suggest that hemostatic and endothelial factors play a pivotal role in the development of cerebral small vessel disease (SVD). Although plasma fibrinogen is an essential factor in the coagulation cascade, the relationship among fibrinogen, cognitive function, and SVD has not been clarified in community-based Asian populations. Because fibrinogen levels of Asians have been reported to be lower than these of Caucasians, the impact of fibrinogen on the development of SVD or dementia in Asians may be different from that of Caucasians.
  
  
  METHODS
  We performed a cross-sectional study using MRI to determine the relationships among fibrinogen, cognitive function, and subclinical SVD in community-based Japanese elderly.
  
  
  RESULTS
  Subjects with raised fibrinogen levels tended to have more lacunes and higher grades of white matter lesions (WMLs). Additionally, an independent association between fibrinogen and WMLs was determined by logistic regression analyses. Subjects with high fibrinogen levels accompanied by high von Willebrand factors or thrombomodulin levels had an increased tendency for the presence of WMLs. The relationship between the mean Mini-Mental State Examination (MMSE) scores and the quartiles of fibrinogen levels was not statistically significant after controlling for age, gender, and WMLs; however, the mean MMSE scores in subjects without WML were related to the tertiles of the fibrinogen levels even after adjusting for conventional risks and high sensitivity C-reactive protein.
  
  
  CONCLUSIONS
  The present study suggests that there is a close relationship between fibrinogen levels and subclinical WMLs, which are independent of conventional risk factors and inflammation, in community-based Japanese elderly.
authors.affiliation: Department of Neurology, Faculty of Medicine, Yamagata University, Japan. mwada@yacht.ocn.ne.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Wada
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Chifumi
authors.initials: C
authors.lastname: Iseki
authors.forename: Toru
authors.initials: T
authors.lastname: Kawanami
authors.forename: Makoto
authors.initials: M
authors.lastname: Daimon
authors.forename: Takeo
authors.initials: T
authors.lastname: Kato
mesh_terms: D000368:Aged; D044466:Asian People; D002561:Cerebrovascular Disorders / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007564:Japan; D056784:Leukoencephalopathies / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D012111:Residence Characteristics; D018180:Thrombomodulin / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: C546931:THBD protein, human; D018180:Thrombomodulin; D014841:von Willebrand Factor; D005340:Fibrinogen