Association Of Cerebral White Matter Lesions With Serum Lipid Level

Objective:To investigate the risk factors of Cerebral white matter lesions,and to analyze the relationship between serum lipid level and Cerebral white matter lesions.Methods:Retrospective collect the data of the patients who were aged 45 years and older and were hospitalized in the first Affiliated Hospital of Xiamen University from June 2017 to April 2018.All patients underwent MRI to assess the presence and severity degree of CWML,using the 4-point modified Fazekas' method to assess the level of CWML.Using multivariate logistic regression analyses explores the association of serum lipids with PVWML and DWML..The serum lipids include total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),apolipoprotein A-I(Apo A-1),and apolipoprotein B(Apo B).The levels of the serum lipid were divided into four quartiles and the highest quartile was used as the reference.Results:1.From June 2017 to April 2018,a total of 272 consecutive patients(132 men and 140 women,65.67±9.61 years)were enrolled in this study.Mild PVWML was found in 78(28.7%),moderate PVWML in 75(27.6%),and severe PVWML in 44(16.1%),while mild DWML was found in 106(39.0%),moderate DWML in 82(30.1%)and severe DWML in 7(2.6%).The prevalence of PVWML and DWML increased with advancing age(P<0.05).2.Patients with PVWML were older than the patients without PVWML(66.97±9.41 VS 61.24±9.35,P<0.001).The results showed that patients with PVWML has higher proportion of male sex(52.8%VS 37.3%,P<0.05),higher prevalence rate of hypertension,diabetes and stroke.The body mass index(BMI),coronary atherosclerotic heart disease,smoking and drinking status were not different between groups The results between patients with DWML and without DWML are similar with the groups of PVWML.Patients with DWML were older than the patients without DWML(67.44±9.72 VS 61.18±7.74,P<0.001).The results showed that patients with DWML has higher proportion of male sex(54.9%VS 32.5%,P<0.05),higher prevalence rate of hypertension,diabetes and stroke(P<0.05).The BMI,coronary atherosclerotic heart disease,smoking and drinking status were not different between the two groups3.The concentration of the serum TC,HDL-C,LDL-C,ApoA-I,and ApoB levels were different between four grades of PVWML and DWML(P<0.05).But the concentration of the serum TG level was no significantly different between four grades of PVWML and DWML(P>0.05).4.After adjustment for age,sex,hypertension,and diabetes,analysis showed that in the groups of PVWML,the serum TC,LDL-C,and ApoB levels were connected with the risk of PVWML,the other serum lipid levels had no connection with-the risk of PVWML.This analysis also showed that in the groups of DWML,the serum LDL-C,and ApoB levels were connected with the risk of DWML,the other serum lipid levels had no connection with the risk of DWML Conclusion:1.Cerebral white matter lesions is connected with age,sex,hypertension,diabetes mellitus and serum lipid level.2.Age and hypertension are the independent risk factors for cerebral white matter lesions.3.Serum levels of TC,LDL-C,ApoB were associated with the risk of having PVWML;serum levels of LDL-C,ApoB were associated with the risk of having DWML.4.Serum levels of TC,LDL-C,ApoB are the risk factors of cerebral white matter lesions.5.The above conclusions illustrated that cerebral white matter lesions was a multivariate disease.