title: Race-ethnicity and cerebral small vessel disease--comparison between Chinese and White populations.
abstract: OBJECTIVE
  Studies in stroke patients suggest that lacunar stroke and intracerebral hemorrhage might be more common in Chinese than Whites. We hypothesized that other manifestations of subclinical cerebral small vessel disease, namely white matter hyperintensities (WMH), lacunes, and microbleeds, are also more common in Chinese than Whites. We compared the community prevalence of these lesions between Han Chinese and White Australians.
  
  
  METHODS
  Magnetic resonance imaging (1·5-Tesla) was performed on participants of the Shanghai Aging Study (n = 321, mean age 69 ± 6 years) and Tasmanian Study of Cognition and Gait (n = 397, mean age 72 ± 7 years). A single-rater recorded measures of WMH, lacunes, and microbleeds. We compared lesion prevalence between age- and gender-matched subgroups from the two cohorts. Among all subjects (n = 718), we performed multivariable logistic regression to examine if race-ethnicity was independently associated with these lesions.
  
  
  RESULTS
  Among age- and gender-matched subjects, confluent WMH were significantly more prevalent in Chinese (38·5%) than Whites (28·4%; P = 0·01). There was no difference in the prevalence of lacunes (Chinese 29·1% vs. Whites 29·5%, P = 0·93) and microbleeds (Chinese 10·1% vs. 9·0%, P = 0·67) between Chinese and Whites. In multivariable logistic regression, Chinese ethnicity was associated with confluent WMH (odds ratio 1·7, 95% confidence interval 1·1-2·6, P = 0·01), but no differences were seen for lacunes and microbleeds. The association between Chinese ethnicity with confluent WMH became insignificant when subjects with history of stroke were excluded.
  
  
  CONCLUSIONS
  In this population-based cross-national comparison, Han Chinese had a higher prevalence of confluent WMH than White Australians, but had a similar prevalence of lacunes and microbleeds.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.forename: Velandai
authors.initials: V
authors.lastname: Srikanth
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.forename: Thanh G
authors.initials: TG
authors.lastname: Phan
authors.forename: Chris
authors.initials: C
authors.lastname: Moran
authors.forename: Shuguang
authors.initials: S
authors.lastname: Chu
authors.forename: Qianhua
authors.initials: Q
authors.lastname: Zhao
authors.forename: Winnie W C
authors.initials: WW
authors.lastname: Chu
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hong
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
authors.forename: Lawrence K S
authors.initials: LK
authors.lastname: Wong
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology / Q000208:ethnology; D059345:Cerebral Small Vessel Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D002681:China / Q000453:epidemiology / Q000208:ethnology; D018672:Community Health Planning; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D059409:Stroke, Lacunar / Q000453:epidemiology
keywords: cross-ethnic comparison; small vessel disease