| Author | Bezerra, D. C. | |
| Author | Sharrett, A. R. | |
| Author | Matsushita, K. | |
| Author | Gottesman, R. F. | |
| Author | Shibata, D. | |
| Author | Mosley Jr, T. H. | |
| Author | Coresh, J. | |
| Author | Szklo, M. | |
| Author | Carvalho, M. S. | |
| Author | Selvin, E. | |
| Access date | 2023-01-31T20:02:54Z | |
| Available date | 2023-01-31T20:02:54Z | |
| Document date | 2011 | |
| Citation | BEZERRA, D. C. et al. Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study. Neurology, v. 78, n. 2, p. 102-108, 2012. | en_US |
| ISSN | 0028-3878 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/56796 | |
| Language | eng | en_US |
| Publisher | American Academy of Neurology | en_US |
| Rights | open access | en_US |
| Title | Risk factors for lacune subtypes in the Atherosclerosis Risk in Communities (ARIC) Study | en_US |
| Type | Article | en_US |
| DOI | 10.1212/WNL.0b013e31823efc42 | |
| Abstract | Objective: Lacunar infarctions are mainly due to 2 microvascular pathologies: lipohyalinosis and microatheroma. Little is known about risk factor differences for these subtypes. We hypothesized that diabetes and glycated hemoglobin (HbA(1)c) would be related preferentially to the lipohyalinotic subtype. Methods: We performed a cross-section analysis of the brain MRI data from 1,827 participants in the Atherosclerosis Risk in Communities study. We divided subcortical lesions ≤ 20 mm in diameter into those ≤ 7 mm (of probable lipohyalinotic etiology) and 8-20 mm (probably due to microatheroma) and used Poisson regression to investigate associations with the number of each type of lesion. Unlike previous studies, we also fitted a model involving lesions <3 mm. Results: Age (prevalence ratio [PR] 1.11 per year; 95% confidence interval [CI] 1.08-1.14), black ethnicity (vs white, PR 1.66; 95% CI 1.27-2.16), hypertension (PR 2.12; 95% CI 1.61-2.79), diabetes (PR 1.42; 95% CI 1.08-1.87), and ever-smoking (PR 1.34; 95% CI 1.04-1.74) were significantly associated with lesions ≤ 7 mm. Findings were similar for lesions <3 mm. HbA(1)c, substituted for diabetes, was also associated with smaller lesions. Significantly associated with 8-20 mm lesions were age (PR 1.14; 95% CI 1.09-1.20), hypertension (PR 1.79; 95% CI 1.14-2.83), ever-smoking (PR 2.66; 95% CI 1.63-4.34), and low-density lipoprotein (LDL) cholesterol (PR 1.27 per SD; 95% CI 1.06-1.52). When we analyzed only participants with lesions, history of smoking (PR 1.99; 95% CI 1.23-3.20) and LDL (PR 1.33 per SD; 95% CI 1.08-1.65) were associated with lesions 8-20 mm. Conclusions: Smaller lacunes (even those <3 mm) were associated with diabetes and HbA(1)c, and larger lacunes associated with LDL cholesterol, differences which support long-held theories relating to their underlying pathology. The findings may contribute to broader understanding of cerebral microvascular disease. | en_US |
| Affilliation | Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore / Oswaldo Cruz Foundation. National School of Public Health. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore. | en_US |
| Affilliation | Department of Neurology Johns Hopkins University School of Medicine, Baltimore. | en_US |
| Affilliation | Department of Radiology. University of Washington Medical Center. Seattle and Department of Medicine Geriatrics. University of Mississippi Medical Center, Jackson. | en_US |
| Affilliation | Department of Radiology. University of Washington Medical Center. Seattle and Department of Medicine Geriatrics. University of Mississippi Medical Center, Jackson. | en_US |
| Affilliation | Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore. | en_US |
| Affilliation | Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore. | en_US |
| Affilliation | Oswaldo Cruz Foundation. National School of Public Health. Rio de Janeiro, RJ, Brazil. | en_US |
| Affilliation | Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore. | en_US |
| Affilliation | University of Mississippi Medical Center Jackson. Mississippi, EUA. | |
| Subject | Atherosclerosis | en_US |
| Subject | Risk Factors | en_US |
| e-ISSN | 1526-632X | |
