Metabolic risks, white matter hyperintensities, and arterial stiffness in high-functioning healthy adults

被引:47
作者
Kuo, Hsu-Ko [2 ,3 ,12 ]
Chen, Ching-Yu [3 ]
Liu, Hon-Man [4 ]
Yen, Chung-Jen [12 ]
Chang, King-Jen [5 ]
Chang, Chien-Cheng [6 ,7 ]
Yu, Yau-Hua [8 ,9 ,10 ]
Lin, Lian-Yu [12 ]
Hwang, Juey-Jen [1 ,11 ,12 ]
机构
[1] Natl Taiwan Univ Hosp, Yun Lin Branch, Dou Liou City 640, Yun Lin County, Taiwan
[2] Natl Taiwan Univ Hosp, Dept Geriatr & Gerontol, Taipei 100, Taiwan
[3] Natl Hlth Res Inst, Div Gerontol Res, Taipei, Taiwan
[4] Natl Taiwan Univ Hosp, Dept Med Imaging, Taipei 100, Taiwan
[5] Natl Taiwan Univ Hosp, Dept Surg, Taipei 100, Taiwan
[6] Acad Sinica, Div Mech, Res Ctr Appl Sci, Taipei 115, Taiwan
[7] Natl Taiwan Univ Hosp, Inst Appl Mech, Taipei 100, Taiwan
[8] Natl Yang Ming Univ, Sch Dent, Taipei 112, Taiwan
[9] Vet Gen Hosp, Dept Dent, Taipei, Taiwan
[10] Vet Gen Hosp, Dept Med Res & Educ, Taipei, Taiwan
[11] Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan
[12] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
关键词
Arterial stiffness; Pulse wave velocity; White matter lesions; Leukoaraiosis; PULSE-WAVE VELOCITY; SMALL-VESSEL DISEASE; STAGE RENAL-DISEASE; HYPERTENSIVE PATIENTS; BLOOD-PRESSURE; DIABETES-MELLITUS; AORTIC STIFFNESS; OLDER-ADULTS; ALL-CAUSE; LESIONS;
D O I
10.1016/j.ijcard.2009.02.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Arterial stiffness, an age-related feature and measured noninvasively by pulse wave velocity (PWV), is associated with a variety of cardiovascular diseases. Although white matter lesion (WML), representing cerebrovascular micro-angiopathy, is typically considered as a preclinical cardiovascular disease, little is know about the association between PWV and WML. The aim of this study is to examine the association between PWV and WML. Method: We examined the extent of white matter lesion on cranial magnetic resonance imaging of 93 participants (mean 72.46 years) from the annual Health Examination for the Elderly Program in the National Taiwan University Hospital. Two subtypes of WML including periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH) were graded according to Fazekas et al. The brachial-ankle PWV (baPWV) and heart-ankle PWV (haPWV) were measured using an automatic waveform analyzer. Results: PVH and DWHM were found in 71 (76%) and 58 (62%) participants. Various degree of WML was observed in 80 (86%) participants. Hypertension, use of anti-hypertensive medications, and elevated blood pressure were identified as risk factors of WML. The baPWV and haPWV were correlated with many metabolic risks, including systolic blood pressure, pulse pressure, and serum triglycerides. The baPWV and haPWV were greater in participants with higher grades of WML in the multivariate analyses. The receiver operating characteristics analyses demonstrated that area under curves for haPWV to identify moderate-to-severe PVH and DWMH were 0.78 (95% confidence interval [CI] 0.66-0.91) and 0.72 (95% CI 0.59-0.85), respectively. Conclusion: Greater PWV is associated with higher grades of WML among high-functioning older adults. Our findings support the notion that measurement of arterial stiffness is useful in clinical practice for detection of preclinical cerebrovascular disease. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:184 / 191
页数:8
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