title: C-reactive protein levels are associated with cerebral small vessel-related lesions.
abstract: OBJECTIVE
  Inflammation has received increasing attention as a cause of stroke. Although several lines of evidence suggest that inflammatory processes have a role in arteriosclerotic vascular events, their involvement remains to be determined. The purpose of this study was to examine the associations between serum high-sensitive C-reactive protein (hs-CRP) levels and cerebral small vessel (CSV)-related lesions as a manifestation of arteriosclerosis.
  
  
  METHODS
  Neurologically normal subjects without any history of neurologic or psychiatric diseases were enrolled (n = 519). All the participants underwent magnetic resonance imaging (MRI), and their CSV-related lesions (i.e., lacunar infarcts, cerebral microbleeds, deep white matter hyperintensity, and periventricular hyperintensity) were evaluated. The serum levels of hs-CRP were evaluated as common inflammatory markers.
  
  
  RESULTS
  Subjects with higher C-reactive protein (CRP) levels had more lacunar infarcts (P = 0.02). After adjusting for the traditional cardiovascular risk factors, higher hs-CRP levels were still associated with the presence of lacunar infarcts [odds ratio for the highest vs the lowest tertile of hs-CRP, 3.57 (95% confidence interval: 1.30-9.80)]. These associations did not change when the logarithmically transformed values for hs-CRP were included. Furthermore, subjects with higher CRP levels had more cerebral microbleeds (P = 0.03), more severe deep white matter hyperintensity (P = 0.04), and periventricular hyperintensity (P = 0.04); however, these associations were not observed after adjusting for the cardiovascular risk factors.
  
  
  CONCLUSIONS
  Higher levels of hs-CRP were associated with lacunar infarcts. Thus, inflammatory processes may be involved in the pathogenesis of small-vessel disease.
authors.affiliation: Department of Neurology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Mitaki
authors.affiliation: Department of Laboratory Medicine, Shimane University School of Medicine, Izumo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nagai
authors.affiliation: Department of Neurology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Oguro
authors.affiliation: Department of Neurology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D059345:Cerebral Small Vessel Diseases / Q000097:blood* / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: cerebral small vessel-related lesions; high-sensitive C-reactive protein; lacunar infarcts; silent brain lesions