| Background With the increasing global aging population,the incidence of cerebral small-vessel disease(CSVD)has significantl y increased.Studies have shown that CSVD can cause 25% of strokes and lead to 45% of dementia cases,seriousl y threatening people’s ph ysica l health.In recent years,it has been discovered that uric acid(UA)and homocysteine(Hcy)may be involved in the occurrence and development of CSVD,but the relationship between them and imaging biomarkers is still controversial.Objective To explore the relationship between UA and Hcy levels with imaging markers in patients with CSVD.Methods A retrospective study was conducted on CSVD patients admitted to the neurology department of the Gezhouba Center Hospital of China National Pharmaceutical Group Co rporation from January 2021 to October 2022.Basic hospitalization information,blood biochemical indicators,and imaging data of the stud y subjects were collected.According to the MR I of the head and Fazekas score scale,CSVD patients were grouped accord ing to whether they had lacunae,and the severit y of white matter h yperintensities(WMH)and enlarged perivascular spaces(EPVS).All data were anal yzed using SPSS 25.0 statistical software,with a significance level of α=0.05.Results1.According to whether the CSVD patients have lacunar infarction or not,they are divided into two groups.The differences in UA and Hcy levels between the lacunar infarction group and the non-lacunar infarction group are statistically significant(P<0.05).Binary logistic regression analysis showed that UA(OR=1.005,95% CI: 1.001-1.009,P=0.010)and Hcy(OR=1.097,95% CI: 1.020-1.180,P=0.013)were independent risk factors for the presence of lacunar infarction in CSVD patients.2.According to the the Fazekas score scale,the severity of WMH in CSCD patients is divided into three groups,the differences in age,smoking history,alcohol consumption history,history of coronary heart disease,blood creatinine level,UA level,and Hcy level among the three groups(mild,moderate,and severe)were statistically significant(P<0.05).Further pairwise comparisons showed that in the mild group compared to the moderate group,the differences in smoking history,alcohol consumption history,blood creatinine level,UA level,and Hcy level were statistically significant(P<0.05);in the mild group compared to the severe group,the differences in age,smoking history,alcohol consumption history,history of coronary heart disease,blood creatinine level,UA level,and Hcy level were statistically significant(P<0.05);and in the moderate group compared to the severe group,the difference in history of coronary heart disease was statistically significant(P<0.05),but the differences in UA and Hcy levels were not statistically significant(P>0.05).Multiple ordinal logistic regression analysis showed that age(OR=1.064,95%CI: 1.026-1.103,P=0.001),UA(OR=1.009,95%CI: 1.005-1.013,P<0.001),and Hcy(OR=1.056,95%CI: 1.003-1.112,P=0.037)were independent risk factors affecting the severity of WMH in CSVD patients.3.According to the distribution of WMH,it can be divided into periventricular white matter hyperintensities(PWMH)and deep white matter hyperintensities(DWMH).According to the Fazekas score scale,the severity of DWMH and PWMH is divided into three groups.Multivariate ordered logistic regression analysis revealed that age(OR=1.076,95% CI:1.037-1.117,P<0.001),uric acid(UA)(OR=1.010,95% CI: 1.006-1.014,P<0.001),and homocysteine(Hcy)(OR=1.085,95% CI: 1.022-1.152,P=0.008)were independent risk factors for the severity of PWMH.Age(OR=1.067,95% CI: 1.024-1.112,P=0.002)and UA(OR=1.005,95% CI: 1.001-1.009,P=0.009)were identified as independent risk factors for the severity of DWMH.4.The comparison of age,history of coronary heart disease,and Hcy levels between the mild and moderate-to-severe EPVS groups showed statistically significant differences(P<0.05).Binary logistic regression analysis revealed that Hcy(OR=1.113,95%CI:1.041-1.190,P=0.002)and age(OR=1.095,95%CI: 1.032-1.162,P=0.003)were independent risk factors affecting the severity of EPVS in patients with CSVD.Conclusion1.UA and Hcy are independent risk factors for the presence of lacunar infarction in CSVD patients.2.The severit y of WM H and PWMH is related to the levels of UA and Hcy,while the severit y of DWMH is related to UA levels but not Hcy levels.3.Hcy promotes the progression of EPVS and is an independent risk factor for the aggravation of EPVS in CSVD patients. |
