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Chen C, Hsu YC, Chou KW, Chang KS, Hsu YH, Chiu WH, Lee CW, Yang PS, Chang WH, Huang YK, Chen PY, Chen CW, Su YJ. NT-proBNP point-of-care testing for predicting mortality in end-stage renal disease: A survival analysis. Heliyon 2024; 10:e30581. [PMID: 38742053 PMCID: PMC11089362 DOI: 10.1016/j.heliyon.2024.e30581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
This study examines the predictive value of elevated N-terminal-pro brain natriuretic peptide (NT-pro BNP) levels for mortality among patients with end-stage renal disease (ESRD). Data from 768 ESRD patients, excluding those with cancer or lost follow-up, were analyzed using Kaplan-Meier curves and Cox proportional hazards models over three years. Results indicated that patients with very high NT-pro BNP levels had shorter average survival times and a significantly higher risk of mortality (hazard ratio 1.43). Advanced age, ICU admission, and comorbidities like cerebrovascular diseases and chronic obstructive pulmonary disease also contributed to increased mortality risks. Thus, elevated NT-pro BNP is an independent risk factor for mortality in ESRD patients.
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Affiliation(s)
- Chun Chen
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yin-Chen Hsu
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kuang-Wei Chou
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Kuo-Song Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Ya-Hui Hsu
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Wei-Huai Chiu
- Graduate Institute of Automation and Control, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Chun-Wei Lee
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Cardiovascular Division, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Sheng Yang
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Department of general surgery, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
- Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan
- School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yao-Kuang Huang
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Division of Thoracic and Cardiovascular Surgery, Chia Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Pang-Yen Chen
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Chien-Wei Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital Chiayi Branch, Chiayi, Taiwan
- Chang Gung University, College of Medicine, Taoyuan, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Yu-Jang Su
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Mackay Junior College of Medicine Nursing and Management, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei, Taiwan
- Division of Toxicology, Mackay Memorial Hospital, Taipei, 10449, Taiwan
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Finch E, Coleman A, Cameron A, Moro C. Utilising interactive technology for stroke patient education: a systematic review. Disabil Rehabil Assist Technol 2024; 19:1236-1248. [PMID: 36622858 DOI: 10.1080/17483107.2022.2161649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 10/26/2022] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE As a leading cause of death and disability worldwide, how to effectively manage and prevent stroke is a key consideration for health care systems. Throughout the world stroke management recommendations include education; however, not all patients receive this intervention. Advances in technology have provided health professionals with a range of innovative, effective, and modern tools that may be useful in delivering stroke education. This study aimed to systematically review the current evidence for the use of interactive technology in stroke patient education, and whether this was effective for increasing patients' stroke knowledge and behaviours that lower stroke risk. METHODS AND MATERIALS The protocol was registered with PROSPERO (#225223) and a literature search undertaken in Embase (including MEDLINE and PubMed), PsycInfo and CINAHL from inception until August 2022. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the included articles. RESULTS From an initial yield of 760 articles, 10 articles met the study inclusion criteria. The articles explored a range of interactive technologies, with none of them includes articles using the same technology. All of the articles reported at least one positive effect from the technology. Two articles reported on stroke incidence post-intervention. The methodological quality of the articles varied, but was largely medium to high. CONCLUSION The paucity of evidence highlights a need for future studies to provide insights into the benefits of quality interactive technology-based stroke education and to identify options for optimal delivery modes in stroke education.
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Affiliation(s)
- Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Adele Coleman
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Ashley Cameron
- Speech Pathology Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- Clinical Support Services, Metro South Health, Brisbane, Australia
| | - Christian Moro
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Zhang Y, Hamidi RE, Hadi M. Cerebral Small Vessel Ischemic Disease: A Source of Patient Panic or a Case of Pragmatic Reporting? Semin Roentgenol 2024; 59:157-164. [PMID: 38880514 DOI: 10.1053/j.ro.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Yi Zhang
- Department of Radiology, University of Louisville, 530 South Jackson Street, CCB-C07, Louisville, KY
| | - Ramin E Hamidi
- Department of Radiology, University of Louisville, 530 South Jackson Street, CCB-C07, Louisville, KY.
| | - Mohiuddin Hadi
- Department of Radiology, University of Louisville, 530 South Jackson Street, CCB-C07, Louisville, KY
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4
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Labeit B, Michou E, Hamdy S, Trapl-Grundschober M, Suntrup-Krueger S, Muhle P, Bath PM, Dziewas R. The assessment of dysphagia after stroke: state of the art and future directions. Lancet Neurol 2023; 22:858-870. [PMID: 37596008 DOI: 10.1016/s1474-4422(23)00153-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/10/2023] [Accepted: 04/14/2023] [Indexed: 08/20/2023]
Abstract
Dysphagia is a major complication following an acute stroke that affects the majority of patients. Clinically, dysphagia after stroke is associated with increased risk of aspiration pneumonia, malnutrition, mortality, and other adverse functional outcomes. Pathophysiologically, dysphagia after stroke is caused by disruption of an extensive cortical and subcortical swallowing network. The screening of patients for dysphagia after stroke should be provided as soon as possible, starting with simple water-swallowing tests at the bedside or more elaborate multi-consistency protocols. Subsequently, a more detailed examination, ideally with instrumental diagnostics such as flexible endoscopic evaluation of swallowing or video fluoroscopy is indicated in some patients. Emerging diagnostic procedures, technical innovations in assessment tools, and digitalisation will improve diagnostic accuracy in the future. Advances in the diagnosis of dysphagia after stroke will enable management based on individual patterns of dysfunction and predisposing risk factors for complications. Progess in dysphagia rehabilitation are essential to reduce mortality and improve patients' quality of life after a stroke.
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Affiliation(s)
- Bendix Labeit
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany; Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany.
| | - Emilia Michou
- Department of Speech Language Therapy, School of Health Rehabilitation Sciences, University of Patras, Patras, Achaia, Greece; Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | - Shaheen Hamdy
- Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | | | - Sonja Suntrup-Krueger
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany
| | - Paul Muhle
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Muenster, Germany; Institute for Biomagnetism and Biosignal Analysis, University Hospital Muenster, Muenster, Germany
| | - Philip M Bath
- Stroke Trials Unit, Mental Health & Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Rainer Dziewas
- Department of Neurology and Neurorehabilitation, Klinikum Osnabrueck-Academic Teaching Hospital of the WWU Muenster, Osnabrueck, Germany
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5
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Jeda AS, Zarei A, Ghabeshi S, Tabibzadeh A, Lotfi M, Etemadifar M, Niya MHK, Ghorbanlou M, Esghaei M. Evaluation of the prevalence of bovine leukemia virus DNA in peripheral blood mononuclear cells of multiple sclerosis patients. IJID REGIONS 2023; 7:233-236. [PMID: 37351152 PMCID: PMC10282537 DOI: 10.1016/j.ijregi.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/28/2023] [Accepted: 04/03/2023] [Indexed: 06/24/2023]
Abstract
Multiple sclerosis (MS) is an immune system-mediated neurodegenerative disease. Recent studies suggest that viral agents, especially the Epstein Barr virus (EBV), are etiological agents for MS. The roles of other viruses in MS have been investigated. Studies have shown an increase in the level of antibodies against bovine leukemia virus (BLV) in patients with MS. In this regard, our study aimed to examine the presence of BLV DNA in peripheral blood mononuclear cells (PBMCs) of MS patients in Iran. In this cross-sectional study, the presence of BLV in 109 Iranian MS patients and 60 healthy controls was evaluated. The isolated PBMCs were used for DNA extraction and PCR, using specific primers for two distinct genes. The mean age of the participants was 39 ± 9.5 years, and 27 (24.77%) of them were male. Clinical evaluation of these patients showed the most frequent MS type to be relapsing-remitting MS (RRMS) (71; 65.14%). BLV evaluation did not show any BLV DNA presence in the PBMCs of individuals in either the MS or healthy control groups. Therefore, our study showed no evidence of BLV infection in Iranian MS patients.
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Affiliation(s)
- Ali Salimi Jeda
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Anna Zarei
- Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soad Ghabeshi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Tabibzadeh
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Lotfi
- Quality Control Department, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
| | - Masoud Etemadifar
- Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mehrdad Ghorbanlou
- Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Fang R, Hu H, Zhou Y, Wang S, Mei Z, She R, Peng X, Jiang Q, Wang X, Xie L, Lin H, Meng P, Zhang K, Wang W, Xie Y, Liu L, Tong J, Wu D, Luo Y, Liu C, Lu Y, Yu S, Cheng S, Xu L, Fang Z, Shang H, Ge J. Efficacy and safety of naotaifang capsules for hypertensive cerebral small vessel disease: Study protocol for a multicenter, randomized, double-blind, placebo-controlled clinical trial. Front Pharmacol 2023; 13:967457. [PMID: 36686705 PMCID: PMC9853990 DOI: 10.3389/fphar.2022.967457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/31/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Hypertensive cerebral small vessel disease (HT-CSVD) is a cerebrovascular clinical, imaging and pathological syndrome caused by hypertension (HT). The condition manifests with lesions in various vessels including intracranial small/arterioles, capillaries, and small/venules. Hypertensive cerebral small vessel disease has complex and diverse clinical manifestations. For instance, it can present as an acute stroke which progresses to cause cognitive decline, affective disorder, unstable gait, dysphagia, or abnormal urination. Moreover, hypertensive cerebral small vessel disease causes 25-30% of all cases of ischemic strokes and more than 50% of all cases of single or mixed dementias. The 1-year recurrence rate of stroke in cerebral small vessel disease patients with hypertension is 14%. In the early stage of development, the symptoms of hypertensive cerebral small vessel disease are concealed and often ignored by patients and even clinicians. Patients with an advanced hypertensive cerebral small vessel disease manifest with severe physical and mental dysfunction. Therefore, this condition has a substantial economic burden on affected families and society. Naotaifang (NTF) is potentially effective in improving microcirculation and neurofunction in patients with ischemic stroke. In this regard, this multicenter randomized controlled trial (RCT) aims to furtherly evaluate the efficacy and safety of naotaifang capsules on hypertensive cerebral small vessel disease. Methods: This study is a multicenter, randomized, double-blind, placebo-controlled clinical trial. A total of 388 eligible subjects were recruited from the First Hospital of Hunan University of Chinese Medicine, Hunan Academy of Chinese Medicine Affiliated Hospital, the First Hospital of Shaoyang University, the First Traditional Chinese Medicine Hospital of Changde, and Jiangmen Wuyi Hospital of Traditional Chinese Medicine from July 2020 to April 2022. After a 4-week run-in period, all participants were divided into the intervention group (represented by Y-T, N-T) and control group (represented by Y-C, N-C); using a stratified block randomized method based on the presence or absence of brain damage symptoms in hypertensive cerebral small vessel disease (represented by Y and N). The Y-T and N-T groups were administered different doses of naotaifang capsules, whereas Y-C and N-C groups received placebo treatment. These four groups received the treatments for 6 months. The primary outcome included Fazekas scores and dilated Virchow-robin spaces (dVRS) grades on magnetic resonance imaging (MRI). The secondary outcomes included the number of lacunar infarctions (LI) and cerebral microbleeds (CMB) on magnetic resonance imaging, clinical blood pressure (BP) level, traditional Chinese medicine (TCM) syndrome scores, mini-mental state examination (MMSE) scale, and safety outcomes. Fazekas scores, dilated Virchow-robin spaces grades, and the number of lacunar infarctions and cerebral microbleeds on magnetic resonance imaging were tested before enrollment and after 6 months of treatment. The clinical blood pressure level, traditional Chinese medicine syndrome scores, mini-mental state examination scale and safety outcomes were tested before enrollment, after 3-month, 6-month treatment and 12th-month follow-up respectively. Conclusion: The protocol will comfirm whether naotaifang capsules reduce Fazekas scores, dilated Virchow-robin spaces grades, and the number of lacunar infarctions and cerebral microbleeds, clinical blood pressure, increase mini-mental state examination scores, traditional Chinese medicine syndrome scores of Qi deficiency and blood stasis (QDBS), and improve the quality of life of subjects. The consolidated evidence from this study will shed light on the benefits of Chinese herbs for hypertensive cerebral small vessel disease, such as nourishing qi, promoting blood circulation and removing blood stasis, and dredging collaterals. However, additional clinical trials with large samples and long intervention periods will be required for in-depth research. Clinical Trial registration: www.chictr.org.cn, identifier ChiCTR1900024524.
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Affiliation(s)
- Rui Fang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China,Institute of Clinical Pharmacology of Chinese Materia Medica, Hunan Academy of Chinese Medicine, Changsha, Hunan, China
| | - Hua Hu
- Neurology Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yue Zhou
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Shanshan Wang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Zhigang Mei
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Ruining She
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiwen Peng
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Qiling Jiang
- School of Food and Chemical Engineering, Shaoyang University, Shaoyang, Hunan, China
| | - Xiangyuan Wang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Le Xie
- Neurology Department, Hunan Academy of Chinese Medicine Affiliated Hospital (Hunan Provincial Hospital of Integrated Chinese and Western Medicine), Changsha, Hunan, China
| | - Hongyuan Lin
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Pan Meng
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Kun Zhang
- Radiology Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Wei Wang
- Health Management Department, The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yao Xie
- Neurology Department, Hunan Academy of Chinese Medicine Affiliated Hospital (Hunan Provincial Hospital of Integrated Chinese and Western Medicine), Changsha, Hunan, China
| | - Litao Liu
- School of Food and Chemical Engineering, Shaoyang University, Shaoyang, Hunan, China,Scientific Research Department, The First Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, China
| | - Jiao Tong
- Neurology Department,The First Traditional Chinese Medicine Hospital of Changde (Changde Hospital Affiliated to Hunan University of Chinese Medicine), Changde, Hunan, China
| | - Dahua Wu
- Neurology Department, Hunan Academy of Chinese Medicine Affiliated Hospital (Hunan Provincial Hospital of Integrated Chinese and Western Medicine), Changsha, Hunan, China
| | - Yunhua Luo
- Health Management Department, Hunan Academy of Chinese Medicine Affiliated Hospital (Hunan Provincial Hospital of Integrated Chinese and Western Medicine), Changsha, Hunan, China
| | - Chang Liu
- Neurology Department,The First Traditional Chinese Medicine Hospital of Changde (Changde Hospital Affiliated to Hunan University of Chinese Medicine), Changde, Hunan, China
| | - Yifang Lu
- Health Management Department, The First Affiliated Hospital of Shaoyang University, Shaoyang, Hunan, China
| | - Shangzhen Yu
- Neurology Department, Jiangmen Wuyi Hospital of Traditional Chinese Medicine (Jiangmen Hospital of Traditional Chinese Medicine Affiliated to Jinan University), Jiangmen, Guangdong, China
| | - Shaowu Cheng
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Linyong Xu
- School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Zhuyuan Fang
- Jiangsu Province Innovation Center of TCM Hypertension Clinical Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Najing, Jiangsu, China,*Correspondence: Zhuyuan Fang, ; Hongcai Shang, ; Jinwen Ge,
| | - Hongcai Shang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Zhuyuan Fang, ; Hongcai Shang, ; Jinwen Ge,
| | - Jinwen Ge
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China,Institute of Clinical Pharmacology of Chinese Materia Medica, Hunan Academy of Chinese Medicine, Changsha, Hunan, China,*Correspondence: Zhuyuan Fang, ; Hongcai Shang, ; Jinwen Ge,
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Nam KW, Kwon HM, Park JH, Kwon H. The Atherogenic Index of Plasma is Associated With Cerebral Small Vessel Disease: A Cross-Sectional Study. J Lipid Atheroscler 2022; 11:262-271. [PMID: 36212747 PMCID: PMC9515737 DOI: 10.12997/jla.2022.11.3.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/17/2022] [Accepted: 05/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Recently, the lipid profile of atherogenic dyslipidemia has become important in cerebrovascular diseases. Atherogenic index of plasma (AIP), an index that reflects this lipid profile as a single number, has been proposed, but there are still few related studies in cerebrovascular disease. In this study, we evaluated the relationship between AIP and cerebral small vessel disease (cSVD) in health check-up participants. Methods We assessed consecutive health check-ups participants between 2006 and 2013. cSVD was measured including the following three subtypes: white matter hyperintensity (WMH), lacuens, and cerebral microbleeds (CMBs). WMH quantitatively measured the volume, and lacunes and CMBs qualitatively evaluated the presence. AIP was calculated according to the following formula based on blood test results: AIP=log [triglyceride (mg/dL)/high-density lipoprotein cholesterol (mg/dL)]. Results A total of 3,170 participants were evaluated (mean age: 56.5 years, male sex: 53.8%). In multivariable linear regression analysis, AIP (β=0.129, 95% confidence interval [CI]=0.003–0.255) was associated with WMH. Age, hypertension, diabetes, lipid-lowering agents, and intracranial atherosclerosis were also associated with WMH volume. In multivariable logistic regression analysis, AIP (adjusted odds ratio=1.72 1.79, 95% CI=1.03–2.90) showed close association with lacunes. Age and intracranial atherosclerosis were also related to lacunes. CMBs did not show a statistically significant association with AIP. Conclusion High AIP was associated with cSVD in health check-up participants. Since this close relationship was only seen in WMH and lacunes, these subtypes may have arisen from a more atherosclerosis-related pathology.
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Affiliation(s)
- Ki-Woong Nam
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyung-Min Kwon
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin-Ho Park
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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