Plasma lipids and cerebral small vessel disease
Neurology. 2014-10-15; 83(20): 1844-1852
DOI: 10.1212/wnl.0000000000000980
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Schilling S(1), Tzourio C(1), Dufouil C(1), Zhu Y(1), Berr C(1), Alpérovitch
A(1), Crivello F(1), Mazoyer B(1), Debette S(2).
Author information:
(1)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.
(2)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.
.
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.
© 2014 American Academy of Neurology.