国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Association of inflammatory markers with cerebral small vessel disease in community-based population
基本信息
- 负责人：Lingling Jiang,Xueli Cai
- 数据来源： PRECISE
- 论文编号：PRECISE20210219
- 发表时间：2022-05-06
2022-05-06
已发表文章
主要研究背景及目的
Inflammation plays a critical role in pathophysiology of CSVD. Studies have consecutively shown a close association between alterations in biomarkers of inflammation and CSVD. Emerging evidences have indicated that components of haematological inflammatory system (neutrophils, lymphocytes, and platelets) were strongly correlated with vascular diseases. Neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) derived from blood cell counts can suitably reflect the immune status. Increased NLR and SII were found to be correlated to deterioration of vascular diseases and supposed to be a powerful prognosis predictor of these diseases. To the best of our knowledge, correlation of NC, NLR and SII with CSVD have not been investigated adequately. Current reports indicated that elevated NLR was associated with volume of white matter hyperintensity (WMH) in a healthy population and with white matter microstructure in Parkinson's disease, while SII was related to white matter microstructure in COVID-19 survivors. Nevertheless, the relationships of NC, NLR and SII with presence and severity of CSVD and imaging phenotypes remain unknown. In this study, we evaluated the associations of NC, NLR and SII with presence of CSVD, CSVD burden, and imaging markers, including WMH, lacune, cerebral microbleeds (CMBs) and enlarged perivascular spaces in the basal ganglia (BG-EPVS), in a relatively large community population cohort. Furthermore, we explored the performance of NC, NLR and SII added to the basic model including traditional vascular risk factors.
方法
A total of 3052 community-dwelling residents from the Poly-vasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were involved in this cross-sectional study. CSVD burden and imaging markers, including white matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces in basal ganglia (BG-EPVS), were assessed according to total CSVD burden score. The associations of NC, NLR and SII with CSVD and imaging markers were evaluated using logistic regression models. Furthermore, two-sample Mendelian randomization (MR) analysis was performed to investigate the genetically predicted effect of NC on CSVD. The prognostic performances of NC, NLR and SII for the presence of CSVD were assessed.
结论
This community-based population study found a suggestive association between NC and CSVD, especially for BG-EPVS and lacune, and provided evidence supporting the prognostic significance of NC.
主要结果
At baseline, the mean age was 61.2 ± 6.7 years, and 53.5% of the participants were female. Higher NC was suggestively associated with increased total CSVD burden and modified total CSVD burden (Q4 vs. Q1: common odds ratio (cOR) 1.33, 95% CI 1.05–1.70; cOR 1.28, 95% CI 1.02–1.60) and marginally correlated with the presence of CSVD (OR 1.29, 95% CI 1.00–1.66). Furthermore, elevated NC was linked to a higher risk of lacune (OR 2.13, 95% CI 1.25–3.62) and moderate-to-severe BG-EPVS (OR 1.67, 95% CI 1.14–2.44). A greater NLR was related to moderate-to-severe BGEPVS (OR 1.68, 95% CI 1.16–2.45). Individuals with a higher SII had an increased risk of modified WMH burden (OR 1.35, 95% CI 1.08–1.69) and moderate-to-severe BG-EPVS (OR 1.70, 95% CI 1.20–2.41). MR analysis showed that genetically predicted higher NC was associated with an increased risk of lacunar stroke (OR 1.20, 95% CI 1.04–1.39) and small vessel stroke (OR 1.21, 95% CI 1.06–1.38). The addition of NC to the basic model with traditional risk factors improved the predictive ability for the presence of CSVD, as validated by the net reclassification index and integrated discrimination index (all p < 0.05).