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Open AccessArticle

Cerebral White Matter Hyperintensity as a Healthcare Quotient

Research Organization for Regional Alliance, Kochi University of Technology, Kochi 782-0003, Japan
Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
ImPACT Program of Council for Science, Technology and Innovation (Cabinet Office, Government of Japan), Tokyo 100-8974, Japan
Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Morioka 028-3694, Japan
Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(11), 1823;
Received: 18 August 2019 / Revised: 24 October 2019 / Accepted: 27 October 2019 / Published: 1 November 2019
(This article belongs to the Special Issue Clinical Medicine for Healthcare and Sustainability)
To better understand the risk factors and optimal therapeutic strategies of cerebral white matter hyperintensity (WMH), we examined a large population of adults with and without various vascular risk factors (VRFs) or vascular risk conditions (VRCs), such as hypertension (HT), diabetes mellitus (DM), and dyslipidemia (DLP), including the comorbidities. We assessed two participant groups having no medical history of stroke or dementia that underwent brain checkup using magnetic resonance imaging (MRI): 5541 participants (2760 men, 2781 women) without VRCs and 1969 participants (1169 men, 800 women) who had received drug treatments for VRCs and the combination of comorbidities. For data analysis, we constructed WMH-brain healthcare quotient (WMH-BHQ) based on the percentile rank of WMH volume. This metric has an inverse relation to WMH. Multiple linear regression analysis of 5541 participants without VRCs revealed that age, systolic blood pressure (SBP), Brinkman index (BI), and female sex were significant factors lowering WMH-BHQ, whereas body mass index (BMI), male sex, fasting blood sugar, and triglyceride levels were increasing factors. The Kruskal–Wallis test and Dunn tests showed that WMH-BHQs significantly increased or decreased with BMI or SBP and with BI classification, respectively. Regarding the impact of impaired fasting glucose and abnormal lipid metabolism, there were almost no significant relationships. For 1969 participants who had HT, DM, and DLP, as well as their comorbidities, we found that DLP played a substantial role in increasing WMH-BHQ for some comorbidities, whereas the presence of HT and DM alone tended to decrease it. Cerebral WMH can be used as a healthcare quotient for quantitatively evaluating VRFs and VRCs and their comorbidities. View Full-Text
Keywords: white matter hyperintensity; MRI; healthcare quotient; chronic white matter hyperintensity; MRI; healthcare quotient; chronic
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Park, K.; Nemoto, K.; Yamakawa, Y.; Yamashita, F.; Yoshida, K.; Tamura, M.; Kawaguchi, A.; Arai, T.; Sasaki, M. Cerebral White Matter Hyperintensity as a Healthcare Quotient. J. Clin. Med. 2019, 8, 1823.

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