DOI: 10.3724/SP.J.1008.2011.00537

Academic Journal of Second Military Medical University (第二军医大学学报) 2011/31:5 PP.537-540

Prevalence and risk factors of silent cerebral infarction in a Chinese population

Objective To observe the prevalence, image findings and risk factors of silent cerebral infarctions (SCI) in healthy subjects undergoing physical examination. Methods A total of 1,008 consecutive subjects, who underwent brain MRI as part of their routine health check from May 2006 to March 2010, were included in the present study. The prevalences of SCI were compared in subjects of different ages and sexes, and the imaging features of the ischemic lesions were summarized. Statistical analysis was performed to assess the association of SCI with common risk factors.Results We identified 328 subjects who had SCI on MRI, with the prevalence being 32.5%, and we also found that 83.4% of the ischemic lesions were lacunar infarcts and mainly located in the frontal lobe, centrum semiovale, basal ganglia, and periventricular white matter. Univariate and multivariate logistic analyses showed that the age, hypertension,diabetes mellitus,low-density lipoprotein cholesterol, lipoprotein α, uric acid and carotid intima-media thickness were statistically significant between SCI and non-SCI patients, and they were the independent factors of SCI.Conclusion SCI is common in Chinese population, and more attention is needed for control of its risk factors.

Key words:silent cerebral infarction,magnetic resonance imaging,risk factor

ReleaseDate:2014-07-21 15:51:06

[1] Masuda J,Nabika T,Notsu Y.Silent stroke: pathogenesis, genetic factors and clinical implications as a risk factor[J].Curr Opin Neurol,2001,14:77-82.

[2] Vermeer S E,Longstreth W T Jr,Koudstaal P J.Silent brain infarcts: a systematic review[J].Lancet Neurol, 2007,6:611-619.

[3] Das R R,Seshadri S,Beiser A S,Kelly-Hayes M,Au R,Himali J J,et al.Prevalence and correlates of silent cerebral infarcts in the Framingham offspring study[J].Stroke,2008,39:2929-2935.

[4] Asumi M,Yamaguchi T,Saito K,Kodama S,Miyazawa H,Matsui H,et al.Are serum cholesterol levels associated with silent brain infarcts?The Seiryo Clinic Study[J].Atherosclerosis,2010,210:644-647.

[5] Lee S C,Park S J,Ki H K,Gwon H C,Chung C S,Byun H S,et al.Prevalence and risk factors of silent cerebral infarction in apparently normal adults[J].Hypertension,2000,36:73-77.

[6] Riley W A.Cardiovascular risk assessment in individual patients from carotid intimal-medial thickness measurements[J].Curr Atheroscler Rep,2004,6:225-231.

[7] Miwa K,Hoshi T,Hougaku H,Tanaka M,Furukado S,Abe Y,et al.Silent cerebral infarction is associated with incident stroke and TIA independent of carotid intima-media thickness[J].Intern Med,2010,49:817-822.

[8] Nomura K,Hamamoto Y,Takahara S,Kikuchi O,Honjo S,Ikeda H,et al.Relationship between carotid intima-media thickness and silent cerebral infarction in Japanese subjects with type 2 diabetes[J].Diabetes Care, 2010,33:168-170.

[9] Vermeer S E,Hollander M,van Dijk E J,Hofman A,Koudstaal P J,Breteler M M;Rotterdam Scan Study.Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study[J].Stroke,2003,34:1126-1129.

[10] Eguchi K,Kario K,Shimada K.Greater impact of coexistence of hypertension and diabetes on silent cerebral infarcts[J].Stroke,2003,34:2471-2474.

[11] Kato T,Inoue T,Yamagishi S,Morooka T,Okimoto T,Node K.Low-density lipoprotein subfractions and the prevalence of silent lacunar infarction in subjects with essential hypertension[J].Hypertens Res,2006,29:303-307.

[12] Shintani S,Kikuchi S,Hamaguchi H,Shiigai T.High serum lipoprotein(a) levels are an independent risk factor for cerebral infarction[J].Stroke,1993,24:965-969.

[13] Fukunaga N,Anan F,Kaneda K,Nawata T,Saikawa T,Yoshimatsu H.Lipoprotein (a) as a risk factor for silent cerebral infarction in hemodialysis patients[J].Metabolism,2008,57:1323-1327.

[14] Heo S H, Lee S H.High levels of serum uric acid are associated with silent brain infarction[J].J Neurol Sci, 2010,297(1-2):6-10.

[15] Novo S,Visconti C L,Amoroso G R,Corrado E,Fazio G,Muratori I,et al.Asymptomatic carotid lesions add to cardiovascular risk prediction[J].Eur J Cardiovasc Prev Rehabil,2010,17:514-518.

[16] Bernick C,Kuller L,Dulberg C,Longstreth W T Jr,Manolio T,Beauchamp N,et al.Silent MRI infarcts and the risk of future stroke: the cardiovascular health study[J].Neurology,2001,57:1222-1229.

[17] Yamashita H,Fujikawa T,Takami H,Yanai I,Okamoto Y,Morinobu S,et al.Long-term prognosis of patients with major depression and silent cerebral infarction[J].Neuropsychobiology,2010,62:177-181.

[18] Vermeer S E,Prins N D,den Heijer T,Hofman A,Koudstaal P J,Breteler M M.Silent brain infarcts and the risk of dementia and cognitive decline[J].N Engl J Med,2003,348:1215-1222.