Abstract
Objective:
Examine the association between lipid profile components and subclinical cerebrovascular disease on magnetic resonance imaging (MRI).
Design/Methods:
Fasting plasma lipids were collected on Northern Manhattan Study participants; a subsample underwent brain MRI (n=1256 with lipids available) a median of 6.2 (range=0-14) years after enrolment, when repeat fasting lipids were obtained (n=1029). We used lipid profile components at the time of initial enrollment as categorical variables, as well as change in clinical categories over the 2 measures. We examined the association between lipid profile components and (1)total white matter hyperintensity volume (WMHV) using linear regression, and (2)silent brain infarcts (SBI) using logistic regression.
Results:
The association between baseline lipids and WMHV was modified by apoE status (chi-squared with 2 degrees of freedom,p=0.03), such that among apoE4 carriers those with total cholesterol (TC)≥200mg/dl ) had a trend towards smaller WMHV than those with TC<200mg/dl (difference in logWMHV -0.19,p=0.07) while there was no difference among apoE3 carriers. A transition from low risk high-density lipoprotein cholesterol (HDL-C)(>50 mg/dl for women,>40 mg/dl for men) at baseline to high risk HDL-C at the time of MRI (versus starting and remaining low risk) was associated with greater WMHV (difference in logWMHV 0.34,p-value 0.03). We noted a similar association with transitioning to a TC≥200mg/dl at the time of MRI (difference in logWMHV 0.25,p-value 0.006) There were no associations with SBI.
Conclusions:
The association of plasma lipid profile components with greater WMHV may depend on apoE genotype and worsening HDL and TC risk levels over time.