Circulating Level of Oxidized Low-Density Lipoprotein Correlates with Cerebral Blood Flow in Patients with White Matter Hyperintensities

BACKGROUND: Oxidized low-density lipoprotein (ox-LDL) has been shown to promote atherosclerosis, but data have been limited on its association with white matter hyperintensities (WMH). OBJECTIVE: To assess the relationship of ox-LDL levels with WMH. METHODS AND MATERIAL: This study included 45 patients with WMH, matched for age, sex, and education with 45 healthy controls (HC). Serum ox-LDL concentration was measured in all subjects. Participants were subjected to comprehensive cognitive assessments. Cerebral blood flow (CBF) of the whole brain and brain regions of interest were collected and analyzed using arterial spin labeling (ASL) perfusion magnetic resonance imaging. Further, we correlated brain CBF with ox-LDL levels and executive function score. Linear regression was performed to determine whether ox-LDL levels were correlated risk factor with CBF changes. RESULTS: The concentration of ox-LDL was higher in patients with WMH (184.10 ± 28.34 μg/L) compared with the HC (166.34 ± 29.72 μg/L). CBF in the gray matter (GM) and right precuneus (Pcu.R) of the WMH patients were noticeably lower than those in the HC. In the WMH patient group, significant correlation was found between ox-LDL levels and CBF in the whole brain (r = -0.36, P = 0.017), GM (r = -0.30, P = 0.049), and Pcu.R (r = -0.41, P = 0.006). Furthermore, there were significant negative correlations between trail-making test (TMT) score (TMT-A: r = -0.305, P = 0.042; TMT-B: r = -0.347, P = 0.019), and CBF in the Pcu.R. Linear regression showed that ox-LDL level (B = -2.437, P = 0.018) significantly affected the CBF change in Pcu.R. CONCLUSIONS: Ox-LDL may be an important biomarker suggesting the mechanistic linkage to the decrease of CBF in the precuneus.