Analysis of influencing factors of white matter hyperintensity load in different brain regions among patients with acute ischemic stroke
WANG Xiao-yu
ZHAO Ya-nan
ZHANG Shu-juan
CHEN Zhi-hui
Abstract：Objective To explore the influencing factors of overal white matter hyperintensity(WMH)load and WMH load in different brain regions[periventricular white matter hyperintensity(PWMH)and deep white matter hyperintensity(DWMH)]load in patients with acute ischemic stroke(AIS).Methods A total of 1161 patients hospitalized in The First Affiliated Hospital of Zhengzhou University between July and December 2023 for acute ischemic stroke were included.The load of PWMH and DWMH were graded according to the Fazekas visual grading scale separately.The overal load of WMH(referred to as total WMH)was assessed according to the sum of PWMH and DWMH scores.The influencing factors of total high WMH load,PWMH load and DWMH load were investigated by univariate and multivariate Logistic regression analyses.Results According to Fazekas score,the 1161 patients were divided into low WMH load group(0-2 points,n=493)and high WMH load group(3-6 points,n=668),low PWMH load group(0-1 points,n=560)and high PWMH load group(2-3 points,n=601),low DWMH load group(0-1 points,n=670)and high DWMH load group(2-3 points,n=491).In multivariate Logitic analysis,based on the multiple imputation dataset,age(OR=1.060,95%CI:1.046-1.075,P=0.000;OR=1.060,95%CI:1.046-1.075,P=0.000;OR=1.047,95%CI:1.033-1.060,P=0.000)and a history of ischemic stroke(OR=1.881,95%CI:1.389-2.546,P=0.000;OR=1.508,95%CI:1.132-2.010,P=0.005;OR=1.833,95%CI:1.380-2.434,P=0.000)were the common risk factors of high load ofWMH,PWMH and DWMH,while an increase in estimated glomerular filtration rate(eGFR)served as a common protective factor(b=-0.012,OR=0.988,95%CI:0.979-0.996,P=0.004;b=-0.012,OR=0.988,95%CI:0.980-0.996,P=0.004;b=-0.008,OR=0.992,95%CI:0.983-1.000,P=0.048).In addition,obesity were the risk factors of high WMH(OR=1.620,95%CI:1.100-2.385;P=0.014)and PWMH(OR=1.712,95%CI:1.176-2.494;P=0.005)load,while female(OR=1.521,95%CI:1.118-2.068;P=0.008)and hypertention(OR=1.892,95%CI:1.391-2.573;P=0.000)were the risk factors of high DWMH load.Conclusions Aging,obesity,a history of ischemic stroke,hypertension and a decline in eGFR are independent risk factors of high WMH load in patients with acute ischemic stroke.The risk factors of high PWMH and DWMH load are different.Attention should be paid to explore more risk factors of WMH and controlling them to improve the prognosis of acute ischemic stroke.
Keywords：Ischemic strokeLeukoaraiosisMagnetic resonance imagingRisk factorsLogistic models
Publication Date：2025-12-25
Online Publishing Date：2026-01-23(First online date of this platform, not the publication date of the document)
Pages：11( 1188-1198 )