Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study
Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype. We per...
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| Veröffentlicht in: | Neurology 2012-01, Vol.78 (2), p.102-108 |
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| creator | BEZERRA, D. C SHARRETT, A. R MATSUSHITA, K GOTTESMAN, R. F SHIBATA, D MOSLEY, T. H CORESH, J SZKLO, M CARVALHO, M. S SELVIN, E |
| description | Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype.
We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions |
| doi_str_mv | 10.1212/wnl.0b013e31823efc42 |
| format | Article |
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We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions <3 mm.
Age (prevalence ratio [PR] 1.11 per year; 95% confidence interval [CI] 1.08-1.14), black ethnicity (vs white, PR 1.66; 95% CI 1.27-2.16), hypertension (PR 2.12; 95% CI 1.61-2.79), diabetes (PR 1.42; 95% CI 1.08-1.87), and ever-smoking (PR 1.34; 95% CI 1.04-1.74) were significantly associated with lesions ≤ 7 mm. Findings were similar for lesions <3 mm. HbA(1)c, substituted for diabetes, was also associated with smaller lesions. Significantly associated with 8-20 mm lesions were age (PR 1.14; 95% CI 1.09-1.20), hypertension (PR 1.79; 95% CI 1.14-2.83), ever-smoking (PR 2.66; 95% CI 1.63-4.34), and low-density lipoprotein (LDL) cholesterol (PR 1.27 per SD; 95% CI 1.06-1.52). When we analyzed only participants with lesions, history of smoking (PR 1.99; 95% CI 1.23-3.20) and LDL (PR 1.33 per SD; 95% CI 1.08-1.65) were associated with lesions 8-20 mm.
Smaller lacunes (even those <3 mm) were associated with diabetes and HbA(1)c, and larger lacunes associated with LDL cholesterol, differences which support long-held theories relating to their underlying pathology. The findings may contribute to broader understanding of cerebral microvascular disease.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/wnl.0b013e31823efc42</identifier><identifier>PMID: 22170882</identifier><identifier>CODEN: NEURAI</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Atherosclerosis - epidemiology ; Biological and medical sciences ; Brain - pathology ; Cholesterol, HDL - blood ; Cross-Sectional Studies ; Diabetes Mellitus - epidemiology ; Ethnic Groups - statistics & numerical data ; Female ; Follow-Up Studies ; Glycated Hemoglobin A - metabolism ; Humans ; Hypertension - epidemiology ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Models, Statistical ; Neurology ; Prevalence ; Residence Characteristics - statistics & numerical data ; Risk Factors ; Stroke, Lacunar - classification ; Stroke, Lacunar - epidemiology ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Neurology, 2012-01, Vol.78 (2), p.102-108</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 by AAN Enterprises, Inc. 2012 AAN Enterprises, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c535t-7de8eadb40e5c904e406293614ce4203694507fe997b85ab20a8441ede19e7333</citedby><cites>FETCH-LOGICAL-c535t-7de8eadb40e5c904e406293614ce4203694507fe997b85ab20a8441ede19e7333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25518365$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22170882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BEZERRA, D. C</creatorcontrib><creatorcontrib>SHARRETT, A. R</creatorcontrib><creatorcontrib>MATSUSHITA, K</creatorcontrib><creatorcontrib>GOTTESMAN, R. F</creatorcontrib><creatorcontrib>SHIBATA, D</creatorcontrib><creatorcontrib>MOSLEY, T. H</creatorcontrib><creatorcontrib>CORESH, J</creatorcontrib><creatorcontrib>SZKLO, M</creatorcontrib><creatorcontrib>CARVALHO, M. S</creatorcontrib><creatorcontrib>SELVIN, E</creatorcontrib><title>Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study</title><title>Neurology</title><addtitle>Neurology</addtitle><description>Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype.
We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions <3 mm.
Age (prevalence ratio [PR] 1.11 per year; 95% confidence interval [CI] 1.08-1.14), black ethnicity (vs white, PR 1.66; 95% CI 1.27-2.16), hypertension (PR 2.12; 95% CI 1.61-2.79), diabetes (PR 1.42; 95% CI 1.08-1.87), and ever-smoking (PR 1.34; 95% CI 1.04-1.74) were significantly associated with lesions ≤ 7 mm. Findings were similar for lesions <3 mm. HbA(1)c, substituted for diabetes, was also associated with smaller lesions. Significantly associated with 8-20 mm lesions were age (PR 1.14; 95% CI 1.09-1.20), hypertension (PR 1.79; 95% CI 1.14-2.83), ever-smoking (PR 2.66; 95% CI 1.63-4.34), and low-density lipoprotein (LDL) cholesterol (PR 1.27 per SD; 95% CI 1.06-1.52). When we analyzed only participants with lesions, history of smoking (PR 1.99; 95% CI 1.23-3.20) and LDL (PR 1.33 per SD; 95% CI 1.08-1.65) were associated with lesions 8-20 mm.
Smaller lacunes (even those <3 mm) were associated with diabetes and HbA(1)c, and larger lacunes associated with LDL cholesterol, differences which support long-held theories relating to their underlying pathology. The findings may contribute to broader understanding of cerebral microvascular disease.</description><subject>Atherosclerosis - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Brain - pathology</subject><subject>Cholesterol, HDL - blood</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Ethnic Groups - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Statistical</subject><subject>Neurology</subject><subject>Prevalence</subject><subject>Residence Characteristics - statistics & numerical data</subject><subject>Risk Factors</subject><subject>Stroke, Lacunar - classification</subject><subject>Stroke, Lacunar - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUlvFDEQha0IlAwh_yBCvqDAoYP35RJpNGKJNAIpgJKb5XZXE0MvE7sbNP8ehwwJcOFSdXjfeyr7IXRMySlllL36MXSnpCaUA6eGcWiDYHtoQSVTleLs6hFaEMJMxY02B-hJzl8JKaK2--iAMaqJMWyBri5i_oZbH6YxZdyOCXc-zAPgPNfTdgMZxwFP14CXZaQxh-52xox_-Yq2Gvt-HuIUC_pieXG-eok_TnOzfYoet77LcLTbh-jzm9efVu-q9Ye356vlugqSy6nSDRjwTS0IyGCJAEEUs1xREUAwwpUVkugWrNW1kb5mxBshKDRALWjO-SE6u8vdzHUPTYBhSr5zmxR7n7Zu9NH9rQzx2n0ZvzsulFKaloCTXUAab2bIk-tjDtB1foBxzs4yzggT3PyfpJJra4kspLgjQ_msnKC9v4cSd9ueu3y_dv-2V2zP_nzLvel3XQV4vgN8Dr5rkx9CzA-clNRwJflPd3ekrw</recordid><startdate>20120110</startdate><enddate>20120110</enddate><creator>BEZERRA, D. 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S</creatorcontrib><creatorcontrib>SELVIN, E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BEZERRA, D. C</au><au>SHARRETT, A. R</au><au>MATSUSHITA, K</au><au>GOTTESMAN, R. F</au><au>SHIBATA, D</au><au>MOSLEY, T. H</au><au>CORESH, J</au><au>SZKLO, M</au><au>CARVALHO, M. S</au><au>SELVIN, E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2012-01-10</date><risdate>2012</risdate><volume>78</volume><issue>2</issue><spage>102</spage><epage>108</epage><pages>102-108</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><coden>NEURAI</coden><abstract>Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype.
We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions <3 mm.
Age (prevalence ratio [PR] 1.11 per year; 95% confidence interval [CI] 1.08-1.14), black ethnicity (vs white, PR 1.66; 95% CI 1.27-2.16), hypertension (PR 2.12; 95% CI 1.61-2.79), diabetes (PR 1.42; 95% CI 1.08-1.87), and ever-smoking (PR 1.34; 95% CI 1.04-1.74) were significantly associated with lesions ≤ 7 mm. Findings were similar for lesions <3 mm. HbA(1)c, substituted for diabetes, was also associated with smaller lesions. Significantly associated with 8-20 mm lesions were age (PR 1.14; 95% CI 1.09-1.20), hypertension (PR 1.79; 95% CI 1.14-2.83), ever-smoking (PR 2.66; 95% CI 1.63-4.34), and low-density lipoprotein (LDL) cholesterol (PR 1.27 per SD; 95% CI 1.06-1.52). When we analyzed only participants with lesions, history of smoking (PR 1.99; 95% CI 1.23-3.20) and LDL (PR 1.33 per SD; 95% CI 1.08-1.65) were associated with lesions 8-20 mm.
Smaller lacunes (even those <3 mm) were associated with diabetes and HbA(1)c, and larger lacunes associated with LDL cholesterol, differences which support long-held theories relating to their underlying pathology. The findings may contribute to broader understanding of cerebral microvascular disease.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22170882</pmid><doi>10.1212/wnl.0b013e31823efc42</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurology, 2012-01, Vol.78 (2), p.102-108 |
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| subjects | Atherosclerosis - epidemiology Biological and medical sciences Brain - pathology Cholesterol, HDL - blood Cross-Sectional Studies Diabetes Mellitus - epidemiology Ethnic Groups - statistics & numerical data Female Follow-Up Studies Glycated Hemoglobin A - metabolism Humans Hypertension - epidemiology Magnetic Resonance Imaging Male Medical sciences Middle Aged Models, Statistical Neurology Prevalence Residence Characteristics - statistics & numerical data Risk Factors Stroke, Lacunar - classification Stroke, Lacunar - epidemiology Vascular diseases and vascular malformations of the nervous system |
| title | Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study |
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