What question did this study set out to answer?

To investigate the relationship between methylglyoxal (MGO) levels and white matter hyperintensities (WMH) in patients with acute ischemic stroke due to small artery occlusion.

February 5, 2026

Association Between Plasma Methylglyoxal and White Matter Hyperintensities in MR in Acute Ischemic Stroke Patients With Small Artery Occlusion

Key Points

To investigate the relationship between methylglyoxal (MGO) levels and white matter hyperintensities (WMH) in patients with acute ischemic stroke due to small artery occlusion.
Conducted a prospective study involving 115 patients with first-ever small artery occlusion.
Utilized various MRI techniques to evaluate conventional CSVD biomarkers including WMH and lacunes.
Measured plasma methylglyoxal levels within 72 hours and again between 8 and 14 days after stroke onset.
Employed statistical tests such as T-test, logistic regression, and Spearman correlation analysis for data analysis.
Elevated MGO levels correlated with the presence of CSVD and the severity of WMH.
Specific associations found with deep white matter hyperintensities, showing an odds ratio of 1.004.
Positive correlation observed between MGO and lacunes, with a correlation coefficient of r = 0.225.
No significant difference in MGO levels from admission to discharge.

Abstract

ABSTRACT Background Cerebral small vessel disease (CSVD) is an important risk factor for stroke and cognitive impairment, adversely affecting long‐term outcomes. Methylglyoxal (MGO), a by‐product of glycolysis, is implicated in various vascular complications. Purpose To explore the correlation between MGO and CSVD, particularly with white matter hyperintensities (WMH). Study Type Prospective. Population One hundred and fifteen patients with first‐ever small artery occlusion (SAO) within 72 h of onset were enrolled, with a mean age of 63.83 ± 10.92 years, of whom 75 (65.2%) were male. Field Strength/Sequence 1.5T or 3T; fast spin‐echo for T1‐ and T2‐weighted imaging, fluid‐attenuated inversion recovery (FLAIR), diffusion‐weighted imaging (DWI), and susceptibility‐weighted imaging (SWI). Assessment Two neurologists independently evaluated the conventional MRI biomarkers of CSVD, including WMH, enlarged perivascular spaces, lacunes (LAC), and cerebral microbleeds; fasting blood samples were collected both within 72 h and between 8 and 14 days after the onset of the disease to measure MGO. Statistical Tests T ‐test, Wilcoxon Mann–Whitney test, chi‐square test, Spearman correlation analysis, ANOVA or the Kruskal–Wallis test; logistic regression analysis, intraclass correlation coefficient (ICC). p < 0.05 was considered statistically significant. Results Elevated MGO levels at admission were independently associated with CSVD (odds ratio OR 1.007, 95% confidence interval CI 1.002–1.011), and the severity of WMH (OR 1.004, 95% CI 1.001–1.008) and deep white matter hyperintensities (D‐WMH) (OR 1.004, 95% CI 1.000–1.007). MGO levels also showed a positive correlation with LAC (correlation coefficient r = 0.225) but no significant correlation with periventricular white matter hyperintensities (PV‐WMH) ( r = 0.172, p = 0.066). Furthermore, there was no significant difference in MGO levels between admission and discharge ( t = 1.932, p = 0.056). The reproducibility of MRI parameters was excellent (ICC 0.966–0.976). Data Conclusion Elevated MGO levels in patients with first‐ever SAO were associated with the presence and severity of WMH, particularly D‐WMH. Level of Evidence 1 Technical Efficacy Stage 1

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Association Between Plasma Methylglyoxal and White Matter Hyperintensities in MR in Acute Ischemic Stroke Patients With Small Artery Occlusion

Key Points

Abstract

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