Race-Ethnicity and Cerebral Small Vessel Disease – Comparison between Chinese and White Populations

Author:

Mok Vincent1,Srikanth Velandai2,Xiong Yunyun3,Phan Thanh G.2,Moran Chris2,Chu Shuguang4,Zhao Qianhua5,Chu Winnie W. C.6,Wong Adrian7,Hong Zhen5,Liu Xinfeng3,Wong Lawrence K. S.1,Ding Ding5

Affiliation:

1. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong

2. Stroke and Aging Research Center, Medicine, Southern Clinical School, Monash Medical Centre, Clayton Victoria, Melbourne, Vic., Australia

3. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China

4. Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China

5. Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China

6. Department of Radiology & Organ Imaging, The Chinese University of Hong Kong, Shatin, Hong Kong

7. Department of Psychological Studies and Center for Psychosocial Health and Aging, The Hong Kong Institute of Education, Taipo, Hong Kong

Abstract

Background and Aim Studies in stroke patients suggest that lacunar stroke and intracerebral hemorrhage might be more common in Chinese than Whites. We hypothesized that other manifestations of subclinical cerebral small vessel disease, namely white matter hyperintensities (WMH), lacunes, and microbleeds, are also more common in Chinese than Whites. We compared the community prevalence of these lesions between Han Chinese and White Australians. Methods Magnetic resonance imaging (1·5-Tesla) was performed on participants of the Shanghai Aging Study ( n = 321, mean age 69 ± 6 years) and Tasmanian Study of Cognition and Gait ( n = 397, mean age 72 ± 7 years). A single-rater recorded measures of WMH, lacunes, and microbleeds. We compared lesion prevalence between age- and gender-matched subgroups from the two cohorts. Among all subjects ( n = 718), we performed multivariable logistic regression to examine if race-ethnicity was independently associated with these lesions. Results Among age- and gender-matched subjects, confluent WMH were significantly more prevalent in Chinese (38·5%) than Whites (28·4%; P = 0·01). There was no difference in the prevalence of lacunes (Chinese 29·1% vs. Whites 29·5%, P = 0·93) and microbleeds (Chinese 10·1% vs. 9·0%, P = 0·67) between Chinese and Whites. In multivariable logistic regression, Chinese ethnicity was associated with confluent WMH (odds ratio 1·7, 95% confidence interval 1·1–2·6, P = 0·01), but no differences were seen for lacunes and microbleeds. The association between Chinese ethnicity with confluent WMH became insignificant when subjects with history of stroke were excluded. Conclusions In this population-based cross-national comparison, Han Chinese had a higher prevalence of confluent WMH than White Australians, but had a similar prevalence of lacunes and microbleeds.

Funder

Shanghai Science and Technology Committee

National Health and Medical Research Council (NHMRC) Grants

Publisher

SAGE Publications

Subject

Neurology

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