RT Journal Article
SR Electronic
T1 Plasma lipids and cerebral small vessel disease
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 1844
OP 1852
DO 10.1212/WNL.0000000000000980
VO 83
IS 20
A1 Schilling, Sabrina
A1 Tzourio, Christophe
A1 Dufouil, Carole
A1 Zhu, Yicheng
A1 Berr, Claudine
A1 Alpérovitch, Annick
A1 Crivello, Fabrice
A1 Mazoyer, Bernard
A1 Debette, Stéphanie
YR 2014
UL http://n.neurology.org/content/83/20/1844.abstract
AB 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.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