Correlation between body composition and white matter hyperintensity in patients with acute ischemic stroke

Area of Science:

• Neurology
• Radiology
• Gerontology

Background:

• White matter hyperintensity (WMH) burden is a risk factor for ischemic stroke.
• The association between WMH and obesity is complex and may be influenced by body composition.
• Systematic evaluation of WMH burden and specific body constituents in acute ischemic stroke (AIS) patients is limited.

Purpose of the Study:

• To investigate the relationship between white matter hyperintensity (WMH) burden and disaggregated body constituents in patients with acute ischemic stroke (AIS).
• To determine if specific body composition elements are independently associated with the severity of WMH in AIS patients.

Main Methods:

• A cohort of 352 AIS patients was analyzed.
• Body composition (subcutaneous adipose tissue, erector spinae muscle area, bone density) was assessed using computed tomography.
• WMH burden was evaluated using the Fazekas scale on fluid-attenuated inversion recovery MRI, categorizing severity.

Main Results:

• Patients with moderate-to-severe WMH exhibited lower bone density, smaller erector spinae muscle area, and reduced subcutaneous adipose tissue compared to those with none-to-mild WMH.
• Logistic regression revealed that bone density was independently associated with moderate-to-severe overall WMH (OR=0.98, 95% CI: 0.972-0.992, P<.001).
• Similar independent associations were observed between bone density and periventricular WMH (P-WMH) severity.

Conclusions:

• Bone density is an independent predictor of white matter hyperintensity severity in acute ischemic stroke patients.
• Reduced bone density is associated with increased WMH burden, suggesting a potential link between skeletal integrity and cerebrovascular health.
• Further research is warranted to explore the underlying mechanisms connecting bone density and WMH in the context of AIS.