CIGARETTE-SMOKING IS CORRELATED WITH THE PERIVENTRICULAR HYPERINTENSITY GRADE ON BRAIN MAGNETIC-RESONANCE-IMAGING

Background and Purpose A few studies have observed a significant inver se correlation between cigarette smoking or lipid abnormalities and pe riventricular hyperintensities (PVHs) on T-2-weighted magnetic resonan ce imaging (MRI) scans of the brain, which is surprising because smoki ng and hyperlipidemia are considered risk factors for cerebrovascular disease. We investigated the relation between smoking and lipid abnorm alities and PVHs on T-2-weighted MRIs. Methods MRI scans were performe d in 253 patients over the age of 40 years, and PVHs were assessed ret rospectively by use of a five-point scale. Patients who were receiving medical treatment for hyperlipidemia were excluded. Serum levels of t otal cholesterol, high-density lipoprotein (HDL) cholesterol, and trig lycerides were determined in the fasting state by an automated enzymat ic procedure. The low-density lipoprotein (LDL) cholesterol level was calculated by use of Friedewald's equation. Age, sex, hypertensive sta tus, antihypertensive treatment, presence or absence of diabetes melli tus: and history of stroke were included in the analysis. Results Mult iple linear regression analysis showed that age: hypertension, smoking , and antihypertensive treatment were significantly and independently correlated with the PVH score. The standard partial regression coeffic ients were .39 (P<.0001) for age, .33 (P<.0001) for hypertension, .16 (P=.0062) for smoking, and -.18 (P=.0124) for antihypertensive treatme nt. Hypercholesterolemia (total cholesterol level >220 mg/dL), HDL hyp ocholesterolemia (HDL cholesterol level <40 mg/dL), LDL hypercholester olemia (LDL cholesterol level >130 mg/dL), hypertriglyceridemia (trigl yceride level >150 mg/dL), sex, diabetes mellitus, and a history of st roke were not correlated with the PVH score. Conclusions Cigarette smo king was a weak but significant positive predictor of the PVH score an d was independent of age, hypertension, and antihypertensive treatment . Lipid abnormalities were not related to the PVH score.