Analysis Of Risk Factors For Vascular White Matter Lesions And Its Correlation With Blood Free Fatty Acids

Object:To explore the correlation between blood free fatty acid and vascular white matter lesion（WML）in patients with cerebral small vessel disease,and analyze the risk factors of vascular WML.Methods:This study was a retrospective analysis,and 406 patients who completed head MRI and blood free fatty acid detection in nanhu Neurology Department of China-Japan Friendship Hospital of Jilin University from September 2019 to July 2021 were collected,among which 298 patients met the inclusion criteria.The included patients were divided into groups according to whether they had WML or not.A total of 221 patients with WML were included in the observation group and 77 patients without WML were included in the control group.Observation group received Fazekas score according to WML of head MRI.Gender,age,height,weight,history of hypertension,history of diabetes,history of coronary heart disease,cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,blood homocysteine and blood free fatty acid spectrum,Fazekas score and other related data of included patients were collected for statistical analysis.Results:1.Comparison of general data between the WML group and the control group:age,smoking history,history of hypertension,history of diabetes,low density lipoprotein cholesterol and homocysteine had statistical differences between the two groups（P<0.05）.2.Comparison of blood free fatty acid profiles between WML group and control group:lauric acid,linolenic acid,behenyl acid,xytaric acid,eicosapentaenoic acid,docosahexaenoic acid,totalω-3,ω-3/ω-6 had statistical differences between the two groups（P<0.05）.3.Correlation analysis between blood free fatty acids and Fazekas score:Fazekas score was negatively correlated with lauric acid,linolenic acid,eicosapentaenoic acid and docosahexaenoic acid.There was significant correlation with lauric acid（r _S=-0.539,P<0.001）,linolenic acid（r _S=-0.340,P<0.001）,eicosapentaenoic acid（r _S=-0.303,P<0.001）,docosahexaenoic acid（r _S=-0.392,P<0.001）,and linolenic acid（r _S=-0.340,P<0.001）showed low correlation.4.Multivariate Logistic regression analysis of WML formation:With WML as the dependent variable,age,history of hypertension,history of diabetes,history of smoking,low density lipoprotein cholesterol,homocysteine,lauric acid,linolenic acid,Behenyl acid,xytaric acid,eicosapentaenoic acid,docosahexaenoic acid,totalω-3,ω-3/ω-6 as the statistically different variables,Further multivariate logistic regression analysis showed that age（OR=1.077,95%CI 1.039-1.116,P<0.001）,history of hypertension（OR=3.110,95%CI 1.595-6.062,P=0.001）,and low density lipoprotein cholesterol（OR=1.556,95%CI 1.021-2.370,P=0.040）were risk factors for WML formation.Lauric acid（OR=0.965,95%CI 0.941-0.991,P=0.008）was a protective factor for WML formation.Conclusions:1.Age,history of hypertension and low density lipoprotein cholesterol were independent risk factors for vasogenic WML.2.Lauric acid is an independent protective factor of vasogenic WML,and has a significant negative correlation with the severity of WML,which has certain clinical value.