Association Of Serum Inflammatory Markers With Cerebrovascular Diseases

Background and purpose:There are many community based studies demonstrating the relationship between serum inflammatory markers and cerebrovascular diseases to date.However,these studies rarely systematically include multiple inflammatory markers to explore their associations with various types of cerebrovascular diseases.Therefore,the overall understanding of the roles of inflammatory markers in different types of vascular diseases is still lacking.In the present community based Shunyi study,we aim to systematically investigate the associations between multiple inflammatory markers and different types of cerebrovascular diseases(large artery atherosclerosis,arterial stiffness and dilatation,cerebral small vessel diseases)and to discuss their different roles.This study may provide a basis for further pathophysiological and preventional study of cerebrovascular diseases.Methods:A total of 1153 participants aged 35 years or older in Shunyi District,Beijing,were included,from June 2013 to August 2018.Subjects with a previous history of neurological diseases were excluded.The levels of serum inflammatory markers were measured by Human Magnetic Luminex Assays,one of the advanced Flexible Multi-Analyte Profiling(xMAP)technology.We used carotid plaque and intracranial atherosclerotic stenosis(ICAS)to evaluate large artery atherosclerosis,and used carotid pulse wave velocity(PWV)and stiffness index ? to assess arterial stiffness.The diameters of common carotid artery,basilar artery and the intracranial segment of internal carotid artery(ICA)were used to evaluate arterial dilatation.And lacunes,white matter hyperintensities(WMH)and cerebral microbleeds(CMB)were rated for assessment of cerebral small vessel diseases.Multivariate linear regression and logistic regression analysis were used to investigate the correlation between each serum inflammatory marker and cerebrovascular diseases mentioned above.Results:After adjusting for conventional vascular risk factors as the confounding factors,(1)Large artery atherosclerosis:serum E-selectin,P-selectin,YKL-40 and MMP3 were associated with carotid plaque,while only E-selectin was related to ICAS;(2)Arterial elasticity:IL-6,P-selectin and OPN were associated with carotid PWV,and IL-6,P-selectin and MMP-9 were associated with stiffness index ?.Among them,the correlation between IL-6 and arterial stiffness was more significant.Arterial dilatation:CD40L,hsCRP and OPN were associated with common carotid artery dilatation,IL-6 was significantly associated with basilar artery dilation,whereas YKL-40,MMP-9,IL-6,OPN were negatively correlated with the diameter of the intracranial segment of ICA.(3)Cerebral small vessel disease:VCAM-1 and YKL-40 were correlated with WMH,while the association of VCAM-1 was more significant.ICAM-1 and VCAM-1 were associated with CMBs,and ICAM-1 had a weak protective effect on CMBs.YKL-40 was the only inflammatory marker associated with all three vascular diseases.No correlation was found between Lp-PLA2,TNF-?,MMP-2 and these vascular diseases.Conclusions:Inflammatory markers were correlated with large artery atherosclerosis,arterial stiffness and dilatation,and cerebral small vessel disease to varying degrees.This study confirmed the important roles of inflammation in the occurrence and development of vascular diseases,and demonstrated the specific effects of some inflammatory markers.However some inflammatory markers were not found to have significant differences in their roles in various types of vascular diseases.Further studies investigating the mechanisms of inflammation in the development of cerebrovascular diseases are still needed.