Ki-Woong Nam1, Hyung-Min Kwon2, Han-Yeong Jeong1, Jin-Ho Park2, Hyuktae Kwon1, Su-Min Jeong1. 1. From the Departments of Neurology (K.-W.N., H.-Y.J.) and Family Medicine (J.-H.P., H.K., S.-M.J.), Seoul National University College of Medicine and Seoul National University; and Department of Neurology (H.-M.K.), Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. 2. From the Departments of Neurology (K.-W.N., H.-Y.J.) and Family Medicine (J.-H.P., H.K., S.-M.J.), Seoul National University College of Medicine and Seoul National University; and Department of Neurology (H.-M.K.), Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. hmkwon@snu.ac.kr kkolzzi0@gmail.com.
Abstract
OBJECTIVE: To evaluate the relationship between serum total homocysteine (tHcy) levels and cerebral small vessel disease (cSVD) in a healthy population. METHODS: We included consecutive participants who visited our department for health checkups between 2006 and 2013. We rated white matter hyperintensity volumes using both the Fazekas score and semiautomated quantitative methods. We also evaluated lacunes, cerebral microbleeds, and enlarged perivascular spaces (EPVS), which are involved in cSVD. To assess the dose-dependent relationship between tHcy and cSVD parameters, we scored the burdens of each radiologic marker of cSVD. RESULTS: A total of 1,578 participants were included (age 55 ± 8 years, male sex 57%). In the multivariable analysis, tHcy remained an independent predictor of the white matter hyperintensity volume (B = 0.209; 95% confidence interval [CI] = 0.033-0.385, p = 0.020), presence of cerebral microbleeds (adjusted odds ratio = 2.800; 95% CI = 1.104-7.105, p = 0.030), and moderate to severe EPVS (adjusted odds ratio = 5.906; 95% CI = 3.523-9.901, p < 0.001) after adjusting for confounders. Furthermore, tHcy had positive associations with periventricular Fazekas score (p = 0.001, p for trend <0.001), subcortical Fazekas score (p = 0.003, p for trend = 0.005), and moderate to severe EPVS lesion burden (p < 0.001, p for trend <0.001) in a dose-dependent manner. CONCLUSIONS: Serum tHcy level is correlated with cSVD development in a dose-dependent manner. These findings provide us with clues for further studies of the pathophysiology of cSVD.
OBJECTIVE: To evaluate the relationship between serum total homocysteine (tHcy) levels and cerebral small vessel disease (cSVD) in a healthy population. METHODS: We included consecutive participants who visited our department for health checkups between 2006 and 2013. We rated white matter hyperintensity volumes using both the Fazekas score and semiautomated quantitative methods. We also evaluated lacunes, cerebral microbleeds, and enlarged perivascular spaces (EPVS), which are involved in cSVD. To assess the dose-dependent relationship between tHcy and cSVD parameters, we scored the burdens of each radiologic marker of cSVD. RESULTS: A total of 1,578 participants were included (age 55 ± 8 years, male sex 57%). In the multivariable analysis, tHcy remained an independent predictor of the white matter hyperintensity volume (B = 0.209; 95% confidence interval [CI] = 0.033-0.385, p = 0.020), presence of cerebral microbleeds (adjusted odds ratio = 2.800; 95% CI = 1.104-7.105, p = 0.030), and moderate to severe EPVS (adjusted odds ratio = 5.906; 95% CI = 3.523-9.901, p < 0.001) after adjusting for confounders. Furthermore, tHcy had positive associations with periventricular Fazekas score (p = 0.001, p for trend <0.001), subcortical Fazekas score (p = 0.003, p for trend = 0.005), and moderate to severe EPVS lesion burden (p < 0.001, p for trend <0.001) in a dose-dependent manner. CONCLUSIONS: Serum tHcy level is correlated with cSVD development in a dose-dependent manner. These findings provide us with clues for further studies of the pathophysiology of cSVD.
Authors: Wenjun Deng; David McMullin; Ignacio Inglessis-Azuaje; Joseph J Locascio; Igor F Palacios; Ferdinando S Buonanno; Eng H Lo; MingMing Ning Journal: Neurology Date: 2021-05-13 Impact factor: 11.800
Authors: Yerim Kim; Ju-Hun Lee; Sang-Hwa Lee; Yeo Jin Kim; Chulho Kim; Min Uk Jang; San Jung; Jae-Sung Lim; Mi Sun Oh; Kyung-Ho Yu; Byung-Chul Lee Journal: Front Neurol Date: 2020-12-02 Impact factor: 4.003