Relationship of White-Matter Lesions and Lacunar Infarcts with Cardiovascular Risk Factors

Eun Hee Nah; Han-Ik Cho

doi:10.3343/lmo.2012.2.2.95

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Nah and Cho: Relationship of White-Matter Lesions and Lacunar Infarcts with Cardiovascular Risk Factors

Original Article

Laboratory Medicine General

Laboratory Medicine Online

Laboratory Medicine Online 2012; 2(2): 95-100.

Published online: 30 March 2012

DOI: https://doi.org/10.3343/lmo.2012.2.2.95

Relationship of White-Matter Lesions and Lacunar Infarcts with Cardiovascular Risk Factors

Eun Hee Nah, M.D., Han-Ik Cho, M.D.

Korea Association of Health Promotion, Seoul, Korea.

Corresponding author: Eun Hee Nah, M.D. Korea Association of Health Promotion, 335 Hwagok-ro, Gangseo-gu, Seoul 157-704, Korea. Tel: +82-2-2600-2000, Fax: +82-2-2696-4500, cellonah@hanmail.net

Received 6 September 2011 Revised 18 October 2011 Accepted 31 October 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Magnetic resonance imaging (MRI) findings of white-matter lesions are different from those of lacunar infarcts; however, both these conditions are related to cardiovascular risk factors. This study was performed to investigate the differences in the relationships of white-matter lesions and lacunar infarcts with cardiovascular risk factors and differences between the metabolic characteristics of patients with these conditions.

Methods

We included 4,255 patients who showed neurological deficits during health checkups. These individuals were classified into the following 3 groups on the basis of MRI findings: normal, white-matter lesion, and lacunar infarct. The groups were compared for age; weights; prevalence of metabolic syndrome; and levels of blood pressure, blood glucose, lipid, high sensitivity C-reactive protein, and HbA1c.

Results

Age, body mass index (BMI); waist circumference; levels of blood pressure, blood glucose, triglycerides and HbA1c; and prevalence of metabolic syndrome and its components were the highest in lacunar infarct group, followed by white matter lesion group, and normal group. Age and diastolic blood pressure level were related to white matter lesions, and age, systolic blood pressure level, and blood glucose level were related to lacunar infarcts. Further, the prevalence of the above-mentioned lesions increased with increase of the number of the components of metabolic syndrome.

Conclusions

This study suggests that lacunar infarct is more advanced lesion than white matter lesion. Among all the cardiovascular risk factors, high blood pressure and impaired fasting blood glucose levels were significantly related to white-matter lesions and lacunar infarct.

Keywords: White matter lesion, Lacunar infarct, Cardiovascular risk factors, Metabolic syndrome

Figures and Tables

Fig. 1

Prevalence of white-matter lesions and lacunar infarct according to the number of the components of metabolic syndrome.

P<0.01 derived from χ² tests used to comparison the prevalence of white-matter lesion and lacunar infarct with reference to the number of components of the metabolic syndrome.

Abbreviations: WML, white-matter lesion; LI, lacunar infarct.

Table 1

Prevalence of cerebral small vessel diseases

^*P values were determined by using χ² test for comparing the prevalence of WML and LI in individuals of different age groups.

Abbreviations: WML, white-matter lesion; LI, lacunar infarct.

Table 2

Intergroup differences in patient characteristics and variables

P value derived from one-way analysis of variance test used for intergroup comparison.

^*P<0.05 derived from posthoc comparisons (Dunnett's test) between the normal group and white-matter lesion group; ^†P<0.05 derived from the comparison of variables between the normal gruop and the lacunar infarct group; ^‡P<0.05 derived from the comparison of variables between white-matter lesion group and the lacunar infarct group.

Abbreviations: WML, white-matter lesion; LI, lacunar infarct; BMI, body mass index; WC, waist circumference; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar; TC, total cholesterol; TG, triglyceride; LDL-C, LDL-cholesterol; HDL-C, HDL-cholesterol; hsCRP, high sensitivity C-reactive protein; HbA_1c, hemoglobin A_1c.

Table 3

Odds ratio (95% confidence interval) of multiple regression analysis for cardiovascular risk factors in WML and LI groups^*

^*Multiple regression analysis performed for the WML and LI groups included the following variables: age, sex, smoking, waist circumference, body mass index, systolic and diastolic blood pressure levels, fasting blood glucose levels, total cholesterol levels, triglyceride levels, HDL-C levels, LDL-C levels, hsCRP levels and HbA1c levels.

Abbreviations: WML, white-matter lesion; LI, lacunar infarct; SBP, systolic blood pressure; DBP, diastolic blood pressure; FBS, fasting blood sugar.

Table 4

Prevalence of the components of metabolic syndrome in patients with cerebral small vessel disease

P values were derived from the χ² test used for comparing the prevalence of components of metabolic syndrome between the patients with white-matter lesions and those with lacunar infarcts.

Abbreviations: WML, white-matter lesion; LI, lacunar infarct; TG, triglyceride; HDL-C, HDL-cholesterol.

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