Characteristics of total cerebral small vessel disease burden in octogenarians with cerebral small vessel disease and its relation with serum uric acid levels / 国际脑血管病杂志

ABSTRACT

Objective:To analyze the characteristics of total cerebral small vessel disease (CSVD) burden in octogenarians with CSVD and to investigate its correlation with serum uric acid.Methods:From January 2019 to December 2020, patients with CSVD diagnosed by 3.0 T magnetic resonance imaging (MRI) in Departments of Neurology and Departments of Geriatrics, Liaoning Jinqiu Hospital were enrolled retrospectively. The patients were scored and grouped according to the total CSVD burden assessment standard. Ordered logistic regression analysis was used to investigate the independent influencing factors of the total CSVD burden score, and the Spearman rank correlation method was used to conduct the correlation analysis between serum uric acid and the total CSVD burden score. Results:A total of 217 octogenarians with CSVD were enrolled in the study. Their age was 87.3±4.5 years, 150 were males (69.1%), and their median serum uric acid was 313.0 μmol/L. The total CSVD burden score: 50 patients (23.1%) in 1-point group, 79 (36.4%) in 2-point group, 68 (31.3%) in 3-point group, and 20 (9.2%) in 4-point group. The imaging subtypes of CSVD were mainly asymptomatic lacunar infarcts (ALIs; 98.2%) and white matter hyperintensities (WMHs; 77.0%). The CSVD subtype combination was different between different total CSVD burden score groups. There were only two subtypes in the 1-point group, mainly ALIs (92.0%), and WMHs accounted for only 8.0%. Four subtypes could be observed in other groups, among which ALIS+ WMHs mixed subtype (100% in the 3-point group and the 4-point group) accounts for the highest proportion. The detection rates of cerebral microbleeds (CMBs) and enlarged perivascular spaces (EPVS) increased significantly with the increase of the total CSVD burden score. The 3-point group was 44.1% and 55.9% respectively. Univariate analysis showed that there were significant differences in age, male, hypertension, coronary heart disease, serum uric acid level, high-density lipoprotein cholesterol and the highest quartile of serum uric acid between total CSVD burden score groups ( P<0.05). Multinomial ordinal logistic regression analysis showed that there was significant independent correlation between age (odds ratio 1.074, 95% confidence interval 1.013-1.140; P=0.017), serum uric acid (odds ratio 1.005, 95% confidence interval 1.000-1.009; P=0.032) and the total CSVD burden score. Spearman rank correlation analysis showed that there was a positive correlation between serum uric acid and the total CSVD burden score ( r=0.153, P=0.024). Conclusions:ALIs and WMHs are most common in octogenarians with CSVD. Four subtypes were observed in each group ≥2, and the proportion of EPVS and CMBs also increases with the increase of the total CSVD burden score. There is an independent correlation between serum uric acid and the total CSVD burden in the octogenarians.