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The Prevalence and Risk Factors of Cerebral Microbleeds: A Community-Based Study in China
Qi Luo1, Huidong Tang1, Xinxin Xu2
1Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
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.
Insights
Cerebral microbleeds (CMBs) prevalence in Chinese elderly is similar to other countries. White matter hyperintensities, APOE ε4, and CR1 non-F/F isoform are key risk factors for CMBs.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Cerebral microbleeds (CMBs) are common in healthy elderly individuals.
- Limited data exists on CMB prevalence and risk factors in China's general elderly population.
Purpose of the Study:
- To investigate the prevalence and risk factors of CMBs in a Chinese stroke-free elderly cohort.
- To identify associations between CMBs and cardiovascular risk factors, cerebral small vessel disease (CSVD) markers, and genetic factors.
Main Methods:
- Cross-sectional study of 199 stroke-free elderly participants from Shanghai.
- 3 Tesla MRI for CMB detection and assessment of CSVD markers (white matter hyperintensities, lacunar infarction, enlarged perivascular space).
- Analysis of cardiovascular risk factors and genetic information (APOE, CR1) using Poisson regression.
Main Results:
- Overall CMB prevalence was 12.6%, increasing with age.
- White matter hyperintensities (OR=1.22), APOE ε4+ carrier (OR=2.16), and CR1 non-F/F isoform (OR=7.78) were associated with CMBs.
- Hypertension (OR=2.98) and lacunar infarction (OR=2.39) increased the risk of deep/mixed CMBs.
Conclusions:
- CMB prevalence in this Chinese cohort is comparable to international findings.
- Cardiovascular risk factors, CSVD markers, and specific genetic factors (APOE ε4, CR1 non-F/F) are linked to CMBs.
- Suggests a multifactorial pathogenesis of CMBs in Chinese community-dwelling elderly.
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