Comparative analysis of risk factors in patients with cerebrovascular diseases in Beijing and Xizang population

doi:10.3877/cma.j.issn.1673-9248.2025.03.004

Abstract

Abstract:

Objective

To analyze and compare the risk factors and spatial distribution of white matter lesions (WMLs) in patients with cerebral small vessel disease (CSVD) from Beijing and Xizang.

Methods

CSVD patients hospitalized at Peking University Third Hospital and Xizang Autonomous Region People's Hospital between January 2020 and December 2022 were prospectively recruited. Clinical and cranial magnetic resonance imaging (MRI) data were collected for all patients. The Fazekas scale and the age-related white matter changes (ARWMC) scale were used to evaluate the severity and spatial distribution of WMLs, respectively. Independent samples t-tests and χ² tests were used to compare baseline clinical characteristics between patients from Beijing and Xizang. Within each region, ANOVA and χ² tests compared characteristics across WML severity subgroups. For the Xizang cohort, multivariate logistic regression identified independent risk factors for WML severity (dependent variable), adjusting for female sex, age ≥70 years, hypertension, coronary heart disease, diabetes, hyperlipidemia, smoking, and alcohol consumption.

Results

The study included 351 CSVD patients: Beijing (n=195; mean age 66.5±11.4 years; WML severity: mild=65, moderate=78, severe=52) and Xizang (n=156; mean age 63.9±11.8 years; WML severity: no/mild=53, moderate=65, severe=38). Compared to Beijing, Xizang had a significantly higher prevalence of WMLs (87.1% [136/156] vs 79.0% [154/195]; χ²=4.064, P=0.044). While WML severity grade distribution did not differ regionally regionally (P>0.05)，WML burden measured by ARWMC score was significantly higher in Xizang than in Beijing (median [IQR]: 10 [1, 16] vs 6 [1, 11]; Z=-2.226, P=0.019). Logistic regression identified age (OR=2.910, P=0.004) and hypertension (OR=3.881, P<0.001) as independent risk factors for WML severity in Xizang. WMLs in Xizang were predominantly located in the frontal subcortical and basal ganglia regions (64.7%).

Conclusion

Risk factors, severity, and spatial distribution of WMLs differ between CSVD patients in Xizang and Beijing. Age and hypertension are independent risk factors for WML severity in Xizang, suggesting the critical role of strict hypertension control in CSVD prevention strategies for this population.

Key words: Cerebral small vessel disease, White matter lesions, Risk factors

Weiwei Zhao, Ji Li, Hao Jiao, Xiaoxuan Liu, Yuhua Zhao. Comparative analysis of risk factors in patients with cerebrovascular diseases in Beijing and Xizang population[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(03): 191-197.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9248.2025.03.004

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2025/V19/I03/191

Figures/Tables 4

地区	例数	年龄（岁， $x ¯ ± s$ ）	男性[例（%）]	高血压[例（%）]	糖尿病[例（%）]	冠心病[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
北京	195	66.46±11.35	117（60.0）	132（67.7）	76（39.0）	29（14.9）	49（25.1）	63（32.3）	47（24.1）
西藏	156	63.91±11.83	89（57.1）	84（53.8）	21（13.5）	11（7.7）	29（18.6）	42（29.9）	34（23.1）
统计值		t=2.11	χ²=0.31	χ²=7.02	χ²=28.20	χ²=4.33	χ²=2.14	χ²=0.94	χ²=0.26
P值		0.130	0.577	<0.001	<0.001	0.037	0.143	0.332	0.601

地区	例数	年龄（岁， $x ¯ ± s$ ）	男性[例（%）]	高血压[例（%）]	糖尿病[例（%）]	冠心病[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
北京	195	66.46±11.35	117（60.0）	132（67.7）	76（39.0）	29（14.9）	49（25.1）	63（32.3）	47（24.1）
西藏	156	63.91±11.83	89（57.1）	84（53.8）	21（13.5）	11（7.7）	29（18.6）	42（29.9）	34（23.1）
统计值		t=2.11	χ²=0.31	χ²=7.02	χ²=28.20	χ²=4.33	χ²=2.14	χ²=0.94	χ²=0.26
P值		0.130	0.577	<0.001	<0.001	0.037	0.143	0.332	0.601

地区	例数	年龄（岁， $x ¯ ± s$ ）	男性[例（%）]	高血压[例（%）]	冠心病[例（%）]	糖尿病[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
北京地区	195
轻度	65	63.60±3.13	45（72.5）	41（66.1）	9（12.9）	33（53.2）	12（19.3）	17（27.4）	17（27.4）
中度	78	65.45±2.15	41（45.1）	62（68.1）	12（13.2）	30（33.0）	16（17.6）	23（25.3）	17（18.7）
重度	52	77.20±2.38	21（50）	29（69.0）	8（19.0）	13（30.1）	21（50）	23（54.8）	13（30.1）
统计值		F=9.72	χ²=6.00	χ²=0.37	χ²=0.26	χ²=1.92	χ²=4.02	χ²=2.56	χ²=0.90
P值		0.008	0.199	0.833	0.877	0.384	0.134	0.278	0.638
西藏地区	156
轻度	53	58.23±1.52	33（62.3）	15（28.3）	4（7.5）	7（13.2）	8（15.1）	16（30.2）	18（34）
中度	65	65.40±1.48	29（44.6）	37（56.9）	6（9.2）	6（9.2）	15（23.1）	9（13.8）	13（20）
重度	38	69.29±1.52	24（64.9）	32（84.2）	2（5.3）	8（22.2）	6（15.8）	17（44.7）	13（34.2）
统计值		F=21.20	χ²=12.00	χ²=28.26	χ²=0.53	χ²=2.88	χ²=1.49	χ²=13.65	χ²=3.71
P值		<0.001	0.285	<0.001	0.766	0.237	0.475	0.001	0.157

地区	例数	年龄（岁， $x ¯ ± s$ ）	男性[例（%）]	高血压[例（%）]	冠心病[例（%）]	糖尿病[例（%）]	高脂血症[例（%）]	吸烟[例（%）]	饮酒[例（%）]
北京地区	195
轻度	65	63.60±3.13	45（72.5）	41（66.1）	9（12.9）	33（53.2）	12（19.3）	17（27.4）	17（27.4）
中度	78	65.45±2.15	41（45.1）	62（68.1）	12（13.2）	30（33.0）	16（17.6）	23（25.3）	17（18.7）
重度	52	77.20±2.38	21（50）	29（69.0）	8（19.0）	13（30.1）	21（50）	23（54.8）	13（30.1）
统计值		F=9.72	χ²=6.00	χ²=0.37	χ²=0.26	χ²=1.92	χ²=4.02	χ²=2.56	χ²=0.90
P值		0.008	0.199	0.833	0.877	0.384	0.134	0.278	0.638
西藏地区	156
轻度	53	58.23±1.52	33（62.3）	15（28.3）	4（7.5）	7（13.2）	8（15.1）	16（30.2）	18（34）
中度	65	65.40±1.48	29（44.6）	37（56.9）	6（9.2）	6（9.2）	15（23.1）	9（13.8）	13（20）
重度	38	69.29±1.52	24（64.9）	32（84.2）	2（5.3）	8（22.2）	6（15.8）	17（44.7）	13（34.2）
统计值		F=21.20	χ²=12.00	χ²=28.26	χ²=0.53	χ²=2.88	χ²=1.49	χ²=13.65	χ²=3.71
P值		<0.001	0.285	<0.001	0.766	0.237	0.475	0.001	0.157

危险因素	B值	Wald值	P值	OR值
北京地区
女性	2.427	7.130	0.008	11.325
年龄≥70岁	1.861	5.282	0.022	6.430
高血压	1.626	6.525	0.014	4.350
冠心病	0.359	0.109	0.741	1.432
糖尿病	-1.586	3.213	0.073	0.205
高脂血症	1.38	2.635	0.105	3.975
脑卒中史	1.528	2.63	0.105	4.609
吸烟	0.339	0.086	0.77	1.404
饮酒	1.468	1.921	0.166	4.341
西藏地区
女性	0.187	0.251	0.616	1.206
年龄≥70岁	1.068	8.251	0.004	2.910
高血压	1.356	14.096	<0.001	3.881
冠心病	-0.37	0.612	0.545	0.691
糖尿病	-0.079	0.028	0.867	0.924
高脂血症	0.052	0.423	0.902	1.053
吸烟	0.401	0.82	0.365	1.493
饮酒	0.085	0.411	0.836	1.089

地区	例数	存在WMH	严重WMH	额叶区	顶枕叶区	颞叶区	基底节区	幕下区
西藏	156	136（87.2）	38（24.4）	132（84.6）	120（76.9）	66（42.3）	101（64.7）	44（28.2）
北京	195	154（79.0）	52（26.7）	160（82.1）	145（74.3）	82（42.1）	82（42.1）	62（31.7）
χ²值		4.06	0.24	0.41	0.31	0.00	17.88	0.53
P值		0.044	0.623	0.523	0.579	0.961	<0.001	0.467

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