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Association Between Plasma Methylglyoxal and White Matter Hyperintensities in MR in Acute Ischemic Stroke Patients
Lei Liu1, Chenchen Wei1, Aijun Ma1
1Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Background:
Cerebral small vessel disease (CSVD) is an important risk factor for stroke and cognitive impairment, adversely affecting long-term outcomes. Methylglyoxal (MGO), a by-product of glycolysis, is implicated in various vascular complications.
Purpose:
To explore the correlation between MGO and CSVD, particularly with white matter hyperintensities (WMH).
Study Type:
Prospective.
Population:
One hundred and fifteen patients with first-ever small artery occlusion (SAO) within 72 h of onset were enrolled, with a mean age of 63.83 ± 10.92 years, of whom 75 (65.2%) were male.
Field Strength/Sequence:
1.5T or 3T; fast spin-echo for T1- and T2-weighted imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), and susceptibility-weighted imaging (SWI).
Assessment:
Two neurologists independently evaluated the conventional MRI biomarkers of CSVD, including WMH, enlarged perivascular spaces, lacunes (LAC), and cerebral microbleeds; fasting blood samples were collected both within 72 h and between 8 and 14 days after the onset of the disease to measure MGO.
Statistical Tests:
T-test, Wilcoxon Mann-Whitney test, chi-square test, Spearman correlation analysis, ANOVA or the Kruskal-Wallis test; logistic regression analysis, intraclass correlation coefficient (ICC). p < 0.05 was considered statistically significant.
Results:
Elevated MGO levels at admission were independently associated with CSVD (odds ratio [OR] 1.007, 95% confidence interval [CI] 1.002-1.011), and the severity of WMH (OR 1.004, 95% CI 1.001-1.008) and deep white matter hyperintensities (D-WMH) (OR 1.004, 95% CI 1.000-1.007). MGO levels also showed a positive correlation with LAC (correlation coefficient [r] = 0.225) but no significant correlation with periventricular white matter hyperintensities (PV-WMH) (r = 0.172, p = 0.066). Furthermore, there was no significant difference in MGO levels between admission and discharge (t = 1.932, p = 0.056). The reproducibility of MRI parameters was excellent (ICC 0.966-0.976).
Data Conclusion:
Elevated MGO levels in patients with first-ever SAO were associated with the presence and severity of WMH, particularly D-WMH.
Level Of Evidence:
1 TECHNICAL EFFICACY: Stage 1.
Insights
Elevated methylglyoxal (MGO) levels are linked to cerebral small vessel disease (CSVD) and white matter hyperintensities (WMH) in patients with small artery occlusion stroke. This finding highlights MGO
Area of Science:
- Neurology
- Vascular Biology
- Biochemistry
Background:
- Cerebral small vessel disease (CSVD) is a significant risk factor for stroke and cognitive decline.
- Methylglyoxal (MGO), a glycolysis byproduct, is implicated in vascular complications.
Purpose of the Study:
- To investigate the association between MGO levels and CSVD, specifically white matter hyperintensities (WMH).
Main Methods:
- Prospective study of 115 patients with first-ever small artery occlusion (SAO).
- Assessed CSVD biomarkers (WMH, lacunes, microbleeds) using MRI (1.5T/3T).
- Measured MGO levels in blood samples collected within 72 hours and 8-14 days post-onset.
Main Results:
- Elevated MGO levels were independently associated with CSVD and WMH severity, particularly deep WMH (D-WMH).
- MGO showed a positive correlation with lacunes (LAC) but not periventricular WMH (PV-WMH).
- No significant difference in MGO levels was observed between admission and discharge.
Conclusions:
- Higher MGO levels in SAO patients correlate with the presence and severity of WMH, especially D-WMH.
- MGO may play a role in the pathogenesis of CSVD and associated neurological deficits.
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