Age and recurrent stroke are related to the severity of white matter hyperintensities in lacunar infarction patients with diabetes

Figures & data

Figure 1 Different scores of P-WMH.

Notes: (A) One point = “caps” or pencil-thin lining; (B) two points = smooth “halo”; (C) three points = irregular P-WMH extending into the deep white matter.

Abbreviation: P-WMH, paraventricular white matter hyperintensities.

Figure 2 Different scores of D-WMH.

Notes: (A) One point = punctate foci; (B) two points = beginning confluence of foci; (C) three points = large confluence areas.
Abbreviation: D-WMH, deep white matter hyperintensities.

Table 1 Characteristics of lacunar infarction patients with DM according to the scale of P-WMH and D-WMH

Clinical features	Paraventricular white matter hyperintensities		P-value	Deep white matter hyperintensities		P-value
	(175, mild)	(152, severe)		≤1 (206, mild)	≥2 (121, severe)
Age,a years	59.9±8.4	67.6±9.6	0.031	61.3±9	67.3±10	<0.001
Male, no (%)	126 (72%)	84 (55.3%)	0.002	143 (69.4%)	67 (55.4%)	0.011
Hypertension, no (%)	126 (72%)	124 (81.6%)	0.042	151 (73.3%)	99 (81.8%)	0.08
Hyperlipidemia, no (%)	49 (28%)	35 (23%)	0.305	63 (30.6%)	21 (17.4%)	0.008
History of CAD, no (%)	28 (16%)	27 (17.8%)	0.671	32 (15.5%)	23 (19%)	0.417
History of stroke, no (%)	29 (16.6%)	74 (48.7%)	<0.001	41 (19.9%)	62 (51.2%)	<0.001
Smoking, no (%)	108 (61.7%)	57 (37.5%)	<0.001	114 (55.3%)	51 (42.1%)	0.021
NIHSSb	3 (1–5)	3 (2–5)	0.157	3 (1–5)	3 (2–5)	0.032
TGb (mmol/L)	1.57 (1.11–2.55)	1.42 (0.95–1.84)	0.01	1.5 (1.08–2.49)	1.42 (0.95–1.87)	0.062
LDLa (mmol/L)	2.7±0.8	2.5±0.7	0.02	2.7±0.8	2.56±0.75	0.182
HDLa (mmol/L)	1.1±0.3	1.2±0.3	0.027	1.17±0.3	1.25±0.3	0.059
HbA1cb (%)	8.4 (6.9–9.9)	7.5 (6.7–8.8)	0.01	8.3 (7–9.6)	7.4 (6.5–9)	0.006
Glua (mmol/L)	9±3.5	8.4±3.3	0.103	8.9±3.6	8.3±3.2	0.107
HCYb (umol/L)	14 (13–17)	15 (13–19)	0.022	14 (13–17)	16 (13–19)	0.008
BUNb (mmol/L)	4.7 (3.9–6)	4.8 (4.1–5.7)	0.811	4.8 (4–5.9)	4.7 (4–5.7)	0.456
Crb (umol/L)	78 (66–89)	76 (62–93)	0.545	77.7 (65.9–89)	78.4 (62.6–94.5)	0.547
Uria (umol/L)	295.6±82.1	279.9±82.1	0.086	284.5±74.4	294.7±94	0.281

Notes:

a Continuous variables with normal distribution were expressed as mean ± SD;

b Continuous variables with non-normal distribution were expressed as the median (interquartile range).

Abbreviations: DM, diabetes mellitus; P-WMH, paraventricular white matter hyperintensities; D-WMH, deep white matter hyperintensities; CAD, coronary artery atherosclerosis disease; TG, triglycerides; LDL, low-density lipoprotein; HDL, high-density lipoprotein; HbA1c, glycosylated hemoglobin; Cr, blood creatinine; Uri, blood uric acid; HCY, homocysteinemia; BUN, blood urea nitrogen.

Table 2 The results of binary logistic regression analyses on the association between P-WMH and risk factors in lacunar infarction patients with DM

Clinical features	Odds ratio	95% CI	P-value
Age	1.065	1.025–1.106	0.001
Male	1.345	0.555–3.263	0.512
History of hypertension	0.853	0.388–1.875	0.692
History of stroke	5.447	2.659–11.159	<0.001
Smoking	0.458	0.196–1.067	0.07
TG	0.867	0.669–1.124	0.282
LDL	0.77	0.488–1.216	0.263
HDL	0.921	0.327–2.596	0.921
HbA1c	0.856	0.705–1.039	0.116
HCY	1.063	0.989–1.142	0.082

Abbreviations: P-WMH, paraventricular white matter hyperintensities; DM, diabetes mellitus; TG, triglycerides; LDL, low-density lipoprotein; HDL, high-density lipoprotein; HbA1c, glycosylated hemoglobin; HCY, hyperhomocysteinemia.

Table 3 Multivariable models of the association between D-WMH and risk factors in lacunar infarction patients with DM

Clinical features	Odd ratios	95% CI	P-value
Age	1.05	1.013–1.087	0.008
Male	1.579	0.666–3.741	0.3
Hypertension	1.4	0.646–3.038	0.394
Hyperlipidemia	0.376	0.164–0.862	0.021
History of stroke	5.41	2.664–10.986	<0.001
Smoking	0.745	0.327–1.695	0.483
TG	1.041	0.815–1.329	0.749
HDL	1.269	0.463–3.473	0.644
HbA1c	0.865	0.715–1.045	0.133
HCY	1.069	0.997–1.147	0.062

Abbreviations: D-WMH, deep white matter hyperintensities; DM, diabetes mellitus; TG, triglycerides; HDL, high-density lipoprotein; HbA1c, glycosylated hemoglobin; HCY, hyperhomocysteinemia.