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Vascular and non‐vascular risk factors for deep white matter lesions in community‐dwelling elderly subjects
Author(s) -
Yao Hiroshi,
Yuzuriha Takefumi,
Koga Hiroshi,
Takashima Yuki,
Fukuda Kenji,
Endo Koichi,
Uchino Akira,
Ibayashi Setsuro,
Uchimura Hideyuki,
Fujishima Masatoshi,
Iida Mitsuo
Publication year - 2003
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1046/j.1444-1586.2003.00061.x
Subject(s) - medicine , leukoaraiosis , odds ratio , magnetic resonance imaging , white matter , risk factor , stroke (engine) , logistic regression , cardiology , radiology , mechanical engineering , engineering
Background: Traditional risk factors such as hypertension explain some but not all the risk factors for leukoaraiosis or deep white matter lesions (DWML). A previous study suggested that a lower blood concentration of tryptophan was a unique factor related to DWML and the present study sought to further characterize this aspect as one of the presumed non‐vascular risk factors for DWML in subjects without hypertension. Methods: Data from 383 community‐dwelling elderly subjects (121 males, 262 females; mean age, 67.1 years) were analyzed. Participants underwent standardized evaluations including a neurological examination, complete blood chemistry panel, ECG, magnetic resonance imaging (MRI), and plasma amino acid measurements. MRI scans used a 1.0‐tesla superconducting magnet with the spin‐echo technique and fluid‐attenuated inversion‐recovery sequences. Results: The MRI study revealed that greater age (odds ratio [OR] 1.94/10 years), hypertension (OR 1.86), higher cholesterol (OR 1.49/mmol/L), and lower plasma tryptophan concentrations (OR 0.71/10 µmol/L) were independent variables related to DWML. When the same logistic model was applied to lacunar infarction on MRI, age, male gender, and hypertension, but not cholesterol or tryptophan, were associated with lacunar infarction. The association between lower plasma tryptophan concentrations and DWML was significant in normotensive subjects, but not in hypertensive patients. Conclusions: The results of the MRI study suggest that lower plasma tryptophan concentrations contribute to the development of DWML, especially in subjects without classical vascular risk factors such as hypertension. To plan an effective strategy for preventing DWML, future study is needed to elucidate the mechanism by which lower tryptophan concentrations induce DWML.