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Associations between endothelial inflammatory markers and cerebral small vessel disease in a community-based population.

Zhang Xia,Li-Na Jiang,Xueli Cai,Jing Jing,Shan Li,Mengxing Wang,Suying Wang,Xuan Wang,Tiemin Wei,Yongjun Wang,Yuesong Pan,Yilong Wang

Published 2025 in International Journal of Stroke

ABSTRACT

BACKGROUND Endothelial inflammation is involved in cerebral small vessel disease (CSVD) pathogenesis. Vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) are biomarkers of endothelial inflammation. AIMS This study investigated association of VCAM-1 and ICAM-1 with presence of CSVD and CSVD burden. METHODS This cross-sectional study included community residents from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events (PRECISE) study. Fasting venous blood was drawn to assay VCAM-1 and ICAM-1. Cognition was assessed by the Montreal Cognitive Assessment (MoCA). Cognitive impairment was defined as MoCA scores <26. White matter hyperintensity, lacunes, cerebral microbleeds, and enlarged perivascular spaces were evaluated in a 3.0T MRI scanner. CSVD burden was rated according to the criteria of Wardlaw's (score 0-4) and Rothwell's (score 0-6) and classified into 4 grades. Presence of CSVD was defined as CSVD burden score ≥1. RESULTS This study included 2596 participants with a mean age of 61.2 ± 6.7 years and 50.9% of males. Elevated VCAM-1 was associated with increased odds of presence of CSVD (Rothwell: OR=1.16, 95%CI: 1.06-1.26, P=0.001), higher CSVD burden (Wardlaw: cOR=1.11, 95%CI: 1.02-1.21, P=0.02; Rothwell: cOR=1.16, 95%CI: 1.07-1.25, P<0.001), and presence of cognition-impaired CSVD (Rothwell: OR=1.15, 95%CI: 1.05-1.25, P=0.003). VCAM-1 improved net reclassification index and integrated discrimination improvement for presence of CSVD (Rothwell) and cognition-impaired CSVD (Rothwell). However, ICAM-1 was not associated with CSVD and did not improve prediction of CSVD. CONCLUSIONS Endothelial inflammation, especially VCAM-1, was associated with presence of CSVD and higher CSVD burden.

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