2023 年 53 巻 1 号 p. 29-36
Background: Management of hypertension is essential when asymptomatic brain infarction is detected; little is known, however, about the management status of each risk factor for this condition and its association with cerebral ischemic lesions in individuals who have undergone an occupational health checkup.
Purpose: This study investigated the control status of risk factors, especially as those determined by head MRI, chest CT, or carotid ultrasound data, and their effects on cerebrovascular lesions in occupational health checkup participants.
Methods: A total of 103 individuals (56.8 ± 4.7 years old; 93 men, 10 women) aged 40 years or older who had undergone head MRI, chest CT, and carotid ultrasound during an occupational health checkup were included in the study. The association between ischemic lesions detected in the deep white matter and around the lateral ventricles on head MRI and test results for risk factors and treatment-related differences with each factor was statistically analyzed.
Results: Metabolic syndrome, lateral periventricular ischemic lesions, and deep brain white matter ischemic lesions were found in 11.7％, 44.3％, and 44.7％ of patients, respectively. Multiple regression analyses using cerebral ischemic lesion type and the actual value for each risk as explanatory factors and age and sex for moderation showed that total cholesterol (P＝0.02) and LDL (P＝0.048) were independent factors for deep brain white matter ischemic lesions, and that triglyceride level (P＝0.02) was an independent factor for lateral periventricular ischemic lesions. A comparison with clinical attributes between the treated and untreated participants showed that the treatment group had a significantly higher HbA1c (P＝0.03) and tended to have more severe calcification of the thoracic blood vessels, although the difference was not statistically significant.
Conclusions: General management of overall lifestyle-related diseases, including lipid control, is crucial when cerebral ischemic lesions are detected in occupational health checkup participants.
