뇌백질병변과 열공경색의 심혈관계질환 위험인자와의 관계
Relationship of White-Matter Lesions and Lacunar Infarcts with Cardiovascular Risk Factors
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배경: 뇌백질병변과 열공경색은 뇌 MRI상 다른 소견을 보이며, 심혈관계질환 위험인자와 관련이 있다. 본 연구에서는 무증상 뇌백질병변 또는 열공경색과 심혈관계질환 위험요소와의 연관성 및 대사적 특징을 밝히고, 이들 사이에 어떤 차이가 있는지 알아보고자하였다. 방법: 신경학적 증상이 없는 건강검진자 4,255명을 뇌 MRI 소견상병변이 없는 정상군, 뇌백질병변군, 열공경색군으로 나누어, 연령,비만도, 혈압, 혈당, 혈중지질, hsCRP, HbA1c들을 비교해 보았고, 대사증후군 발생빈도를 알아보았다. 결과: 연령, 체질량지수, 허리둘레, 혈압, 혈당, 중성지방, HbA1c가정상군, 뇌백질병변군, 열공경색군으로 갈수록 증가하였고, 대사증후군 및 대사증후군 요소의 유병률이 위와 같은 순으로 증가하였다. 뇌백질병변은 연령, 이완기 혈압과, 열공경색은 연령, 수축기혈압, 공복혈당과 연관성이 있었고, 이 병변들의 유병률은 대사증후군 요소 수가 증가함에 따라 증가하였다. 결론: 뇌백질병변보다 열공경색이 더 진행된 병변이며, 심혈관계질환 위험인자 중, 고혈압, 공복혈당장애가 뇌백질병변 및 열공경색과 연관성이 있었다.
Abstract
Background: Magnetic resonance imaging (MRI) findings of white-matter lesions are different from those of lacunar infarcts; however, both these conditions are related to cardiovascular risk factors. This study was performed to investigate the differences in the relationships of whitematter lesions and lacunar infarcts with cardiovascular risk factors and differences between the metabolic characteristics of patients with these conditions. Methods: We included 4,255 patients who showed neurological deficits during health checkups. These individuals were classified into the following 3 groups on the basis of MRI findings: normal, white-matter lesion, and lacunar infarct. The groups were compared for age; weights; prevalence of metabolic syndrome; and levels of blood pressure, blood glucose, lipid, high sensitivity C-reactive protein, and HbA1c. Results: Age, body mass index (BMI); waist circumference; levels of blood pressure, blood glucose, triglycerides and HbA1c; and prevalence of metabolic syndrome and its components were the highest in lacunar infarct group, followed by white matter lesion group, and normal group. Age and diastolic blood pressure level were related to white matter lesions, and age, systolic blood pressure level, and blood glucose level were related to lacunar infarcts. Further, the prevalence of the above-mentioned lesions increased with increase of the number of the components of metabolic syndrome. Conclusions: This study suggests that lacunar infarct is more advanced lesion than white matter lesion. Among all the cardiovascular risk factors,high blood pressure and impaired fasting blood glucose levels were significantly related to white-matter lesions and lacunar infarct.
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