Data from: Serum homocysteine level is related to cerebral small vessel disease in a healthy population

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 check-ups between 2006 and 2013. We rated white
matter hyperintensity (WMH) volumes using both the Fazekas score and
semi-automated quantitative methods. We also evaluated lacunes, cerebral
microbleeds (CMBs), and enlarged perivascular spaces (EPVSs) which are
involved in cSVD. To assess the dose-dependent relationship between tHcy
and cSVD parameters, we scored the burdens of each radiological 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 WMH volume (B = 0.209; 95% confidence
interval [CI] = 0.033 to 0.385, P = 0.020), presence of CMBs (adjusted
odds ratio [aOR] = 2.800; 95% CI = 1.104 to 7.105, P = 0.030), and
moderate-to-severe EPVSs (aOR = 5.906; 95% CI = 3.523 to 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.

研究目的：评估健康人群血清总同型半胱氨酸（total homocysteine, tHcy）水平与脑小血管病（cerebral small vessel disease, cSVD）之间的关联。
研究方法：纳入2006年至2013年间于本科室接受健康体检的连续性受试者。分别采用Fazekas量表与半自动化定量法评估脑白质高信号（white matter hyperintensity, WMH）体积；同时评估脑小血管病相关的腔隙性脑梗死、脑微出血（cerebral microbleeds, CMBs）及扩大的血管周围间隙（enlarged perivascular spaces, EPVSs）。为探究tHcy与脑小血管病影像学参数的剂量依赖关系，我们对每种脑小血管病影像学标志物的负荷进行评分。
研究结果：共纳入1578名受试者，年龄为55±8岁，男性占比57%。多变量分析结果显示，在校正混杂因素后，血清tHcy水平仍是WMH体积（标准化回归系数B=0.209；95%置信区间（confidence interval, CI）：0.033~0.385，P=0.020）、脑微出血存在情况（校正比值比（adjusted odds ratio, aOR）=2.800；95%CI：1.104~7.105，P=0.030）及中重度扩大的血管周围间隙（aOR=5.906；95%CI：3.523~9.901，P<0.001）的独立预测因子。进一步分析显示，tHcy与脑室周围Fazekas评分（P=0.001，趋势检验P<0.001）、皮层下Fazekas评分（P=0.003，趋势检验P=0.005）及中重度EPVS病变负荷（P<0.001，趋势检验P<0.001）呈剂量依赖性正相关。
研究结论：血清tHcy水平与脑小血管病的发生呈剂量依赖性相关。本研究结果为脑小血管病的病理生理学机制后续研究提供了新的线索。