Plasma level of sICAM-1 is associated with the extent of white matter lesion among asymptomatic elderly subjects
Received 5 February 2009; received in revised form 14 August 2009; accepted 17 August 2009.
Abstract
Objective
Inflammatory endothelial activation mediated by intercellular adhesion molecule-1 (ICAM-1) plays a role in the pathogenesis of large- and small-vessel disease. We explored the association between soluble ICAM-1 (sICAM-1) and white matter lesion (WML) as a manifestation of cerebral small-vessel disease.
Methods
One hundred and seventy-five elderly individuals aged ≥ 60 without neurological deficits were studied. Subcortical deep white matter hyperintensity (SDWMH) and periventricular hyperintensity (PVH) were rated separately. Lesions in each category were then divided into three groups (grade 0-I, grade II, grade III) according to the Fazekas scale.
Results
Plasma sICAM-1 levels were positively associated with grades of WML (for SDWMH: 297.4±135.6ng/mL in grade 0-I, 391.3±145.5ng/mL in grade II, and 450.2±232.9ng/mL in grade III, p<0.001; for PVH: 282.5±116.5ng/mL in grade 0-I, 402.3±160.4ng/mL in grade II, and 428.1±227.7ng/mL in grade III, p<0.001). Multivariate analysis showed higher sICAM-1 levels, age and hypertension were the independent risk factors associated with the presence and severity of WML. More than 4-fold increased risk of WML was observed in patients with the highest quartile of sICAM-1 (all WML OR=4.694, 95% CI: 1.805–12.204; moderate WML OR=4.618, 95% CI: 1.543–13.825; severe WML OR=4.893, 95% CI: 1.236–19.368).
Conclusion
Increased plasma sICAM-1 suggests inflammatory process may be involved in the pathogenesis of WML.
ABSTRACT