The Prevalence and Risk Factors of Cerebral Microbleeds: A Community-Based Study in China
Received 16 December 2020
Accepted for publication 2 February 2021
Published 18 February 2021 Volume 2021:17 Pages 165—171
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Deyun Wang
Qi Luo,1,* Huidong Tang,1,* Xinxin Xu,2 Juan Huang,2 Pei Wang,1 Guiying He,1 Xiaoxuan Song,1 Yumeng Huang,1 Shengdi Chen,1 Fuhua Yan,2 Yuyan Tan,1 Jianfang Ma1
1Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianfang Ma
Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 197, Second Ruijin Road, Shanghai, 200025, People’s Republic of China
Tel/Fax +86 21-6445-4473
Introduction: Cerebral microbleeds (CMBs) are frequently found in the healthy elderly. However, data on the prevalence and risk factors of CMBs in the general population of China are lacking.
Methods: A cross-sectional study focusing on the prevalence and risk factors of CMBs was conducted in stroke-free elderly from Shanghai Wuliqiao community. MRI was performed at 3Tesla and cardiovascular risk factors (eg, age, smoking history, and hypertension), cerebral small vessel disease (CSVD) markers (eg, white matter hyperintensities, lacunar infarction, and enlarged perivascular space) and genetic information (eg, APOE, CR1) were recorded. Poisson regression was used to analyze the risk factors of the presence and location of microbleeds.
Results: A total of 199 participants (70.8± 7.2 years old; male 31.2%) were finally included in our analysis. The overall prevalence of CMBs was 12.6% (25/199) and increased with age from 7.5% (55– 64 years old) to 19.3% (over 75 years old). Of those with CMBs, most of them (16/25) located in the deep/mixed region and had 1– 2 CMBs (18/25). Poisson regression analysis showed that white matter hyperintensities (OR=1.22, 95% CI: 1.16– 1.29), APOE ϵ4+ carrier (OR=2.16, 95% CI: 1.18– 3.96) and CR1 non-F/F isoform (OR=7.78, 95% CI: 4.34– 13.96) were associated with CMBs. Further analysis found that in addition to the above three risk factors, hypertension (OR=2.98, 95% CI: 1.16– 7.64), lacunar infarction (OR=2.39, 95% CI: 1.19– 4.81) also increased the risk of deep/mixed CMBs.
Conclusion: The prevalence of cerebral microbleeds is similar to other countries. Cardiovascular risk factors, CSVD markers, and genetic factors (APOE ϵ4, CR1 non-F/F isoform) were associated with CMBs, suggesting an interaction of multiple pathogenesis in Chinese stroke-free community population.
Keywords: cerebral microbleeds, prevalence, risk factors, community-based study
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