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November 11, 2014; 83 (20) Article

Plasma lipids and cerebral small vessel disease

Sabrina Schilling, Christophe Tzourio, Carole Dufouil, Yicheng Zhu, Claudine Berr, Annick Alpérovitch, Fabrice Crivello, Bernard Mazoyer, Stéphanie Debette
First published October 15, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000980
Sabrina Schilling
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Christophe Tzourio
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Carole Dufouil
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Yicheng Zhu
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Claudine Berr
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Annick Alpérovitch
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Fabrice Crivello
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Bernard Mazoyer
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Stéphanie Debette
From the University of Bordeaux Ségalen (S.S., C.T., C.D., Y.Z., A.A., S.D.), INSERM U897 Neuroepidemiology, Bordeaux, France; Pekin Union Medical College Hospital (Y.Z.), China; Inserm U1061(C.B.), Montpellier; University Montpellier I (C.B.); University Pierre et Marie Curie–Paris 6 (A.A.); CNRS-CEA UMR5296 (F.C., B.M.), Université Bordeaux Segalen, Bordeaux; University of Versailles Saint-Quentin-en-Yvelines (S.D.); Department of Neurology (S.D.), Lariboisière Hospital, Paris; INSERM UMR S-1161 (S.D.), Paris 7 University, France; Department of Neurology (S.D.), Bordeaux University Hospital, Bordeaux; and Department of Neurology (S.D.), Boston University School of Medicine, Framingham Heart Study, Boston, MA.
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Citation
Plasma lipids and cerebral small vessel disease
Sabrina Schilling, Christophe Tzourio, Carole Dufouil, Yicheng Zhu, Claudine Berr, Annick Alpérovitch, Fabrice Crivello, Bernard Mazoyer, Stéphanie Debette
Neurology Nov 2014, 83 (20) 1844-1852; DOI: 10.1212/WNL.0000000000000980

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Abstract

Objectives: We examined the cross-sectional association between lipid fractions and 2 MRI markers of cerebral small vessel disease, white matter hyperintensity volume (WMHV) and lacunes, representing powerful predictors of stroke and dementia.

Methods: The study sample comprised 2,608 participants from the 3C-Dijon Study (n = 1,842) and the Epidemiology of Vascular Aging Study (EVA) (n = 766), 2 large French population-based cohorts (72.8 ± 4.1 and 68.9 ± 3.0 years; 60.1% and 58.4% women, respectively). Analyses were performed separately in each study and combined using inverse variance meta-analysis. Lipid fractions (triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol) were studied as continuous variables. WMHV was studied both in a continuous and dichotomous manner, the latter reflecting the age-specific top quartile of WMHV (EXT-WMHV). Analyses were adjusted for age and sex.

Results: Increasing triglycerides were associated with larger WMHV in the 3C-Dijon Study (β ± SE = 0.0882 ± 0.0302, p = 0.0035), in the EVA Study (β ± SE = 0.1062 ± 0.0461, p = 0.021), and in the combined analysis (β ± SE = 0.0936 ± 0.0252, p = 0.0002) and with higher frequency of lacunes in the 3C-Dijon Study (odds ratio [OR] = 1.65 [95% confidence interval 1.10–2.48], p = 0.015), in the EVA Study (OR = 1.58 [95% confidence interval 0.93–2.70], p = 0.09), and in the combined analysis (OR = 1.63 [95% confidence interval 1.18–2.25], p = 0.003). Associations were attenuated but maintained after adjusting for other vascular risk factors or for inflammatory markers. Associations were present and in the same direction both in participants taking and those not taking lipid-lowering drugs but tended to be stronger in the former for EXT-WMHV. Increasing low-density lipoprotein cholesterol tended to be associated with a decreased frequency and severity of all MRI markers of cerebral small vessel disease in both studies.

Conclusions: Increasing triglycerides but not other lipid fractions were associated with MRI markers of cerebral small vessel disease in older community persons.

GLOSSARY

CI=
confidence interval;
CRP=
C-reactive protein;
DWMHV=
deep white matter hyperintensity volume;
EVA=
Epidemiology of Vascular Aging Study;
EXT-WMHV=
age-specific top quartile of white matter hyperintensity volume;
HDL=
high-density lipoprotein;
IL-6=
interleukin 6;
LDL=
low-density lipoprotein;
OR=
odds ratio;
PVWMHV=
periventricular white matter hyperintensity volume;
SE=
standard error;
SVD=
small vessel disease;
TG=
triglyceride;
WMH=
white matter hyperintensity;
WMHV=
white matter hyperintensity volume

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received February 27, 2014.
  • Accepted in final form August 13, 2014.
  • © 2014 American Academy of Neurology
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