期刊
ATHEROSCLEROSIS
卷 216, 期 2, 页码 461-466出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2011.02.027
关键词
Atherosclerosis; Cerebral small vessel disease; White matter lesion; Lacunar infarct; Homocysteine; Cerebrovascular disease
资金
- Netherlands Organization for Scientific Research-Medical Sciences (NWO-MW) [904-65-095]
- Netherlands Organization for Scientific Research (NWO) [917-66-311]
Objective: High homocysteine level is a risk factor for atherosclerosis and has been associated with lacunar infarcts (LIs), white matter lesions (WML) and cognitive dysfunction. It is unclear whether homocysteine is associated with cerebral small vessel disease (cSVD) on top of pre-existent atherosclerosis. We evaluated the association between homocysteine and cSVD in a large cohort of patients with symptomatic atherosclerotic disease. Methods: Within the SMART-MR study, a prospective cohort study of patients with symptomatic atherosclerotic disease, we estimated cross-sectional associations of total plasma homocysteine (THCY) and hyperhomocysteinemia (HHCY) with WML volume and presence of LI, using automated brain segmentation in MRIs of 1232 patients and cognitive function in 763 patients. WML were expressed as a logarithmic transformed percentage of total brain volume. Results: Linear regression analyses adjusted for age, sex, vascular risk factors and extent of atherosclerosis showed that THCY and HHCY were significantly associated with larger WML volumes (B=0.01%: 95% CI 0.002-0.02%, and B=0.21%: 95% CI 0.04-0.39%). Increasing THCY was significantly associated with an increased risk of LIs (OR 1.04, 95% CI 1.01-1.07, per 1 mu mol). Moreover, HHCY was associated with worse cognitive function (B=-0.12: 95% CI -0.22 to -0.01). Conclusion: In patients with symptomatic atherosclerotic disease, higher homocysteine levels are associated with higher WML volume, presence of LI and slightly worse cognitive function. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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