血清脂蛋白(a)与社区中老年人脑白质高信号严重程度的相关性

Correlation between serum lipoprotein(a)and the severity of white matter hyperintensities in middle-aged and elderly people in the community

目的探讨血清脂蛋白(a)[lipoprotein(a),Lp(a)]与社区中老年人群脑白质高信号(white matter hyperintensities,WMHs)严重程度的相关性。方法回顾性连续收集2016年6月至2021年8月在南京医科大学附属江宁医院神经内科住院体检的居住在社区的中老年人。在入院次日采集空腹静脉血检测Lp(a)水平。住院期间行头颅MRI检查,采用Fazekas视觉评分法对WMHs严重程度进行分级。采用有序多变量logistic回归分析确定WMHs严重程度的独立相关因素。结果共1752例患者纳入分析。男性969例(55.31%),女性783例(44.69%),年龄(66.18±10.32)岁。轻度WMHs组1167例(66.61%),中度WMHs组407例(23.23%),重度WMHs组178例(10.16%)。有序多变量logistic回归分析显示,在调整混杂因素后,血清Lp(a)水平较高与WMHs严重程度存在独立相关性(以第1四分位数作为参照,第3四分位数:优势比1.441,95%置信区间1.050~1.976,P=0.023;第4四分位数:优势比1.717,95%置信区间1.252~2.354,P=0.001)。结论血清Lp(a)与WMHs严重程度独立相关。

Objective To investigate the correlation between serum lipoprotein(a)[LP(a)]and the severity of white matter hyperintensities(WMHs)in the middle-aged and elderly people in the community.Methods Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected.Fasting venous blood was collected on the next day of admission to detect the level of Lp(a).During hospitalization,cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method.Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results A total of 1752 patients were included in the analysis.There were 969 males(55.31%)and 783 females(44.69%).Their age was 66.18±10.32 years old.There were 1167 patients(66.61%)in the mild WMHs group,407(23.23%)in the moderate WMHs group,and 178(10.16%)in the severe WMHs group.Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors,a higher serum Lp(a)level was independently related to the severity of WMHs(with the first quartile as a reference,the third quartile:odds ratio 1.441,95%confidence interval 1.050-1.976,P=0.023;the fourth quartile:odds ratio 1.717,95%confidence interval 1.252-2.354,P=0.001).Conclusion Serum Lp(a)is independently correlated with the severity of WMHs.