Background and Purpose- Serum cholesterol variability, independent of mean, has been associated with stroke, white matter hyperintensities on cranial magnetic resonance imaging (MRI), and other cardiovascular events. We sought to assess the relationship between total serum cholesterol (TC) variability and cranial MRI findings of subclinical or covert vascular brain injury in a longitudinal, population-based cohort study of older adults. Methods- In the Cardiovascular Health Study, we assessed associations between intraindividual TC mean, trend, and variability over ≈5 years with covert brain infarction (CBI) and white matter grade (WMG) on cranial MRI. Mean TC was calculated for each study participant from 4 annual TC measurements between 2 MRI scans. TC trend was calculated as the slope of the linear regression of the TC measurements, and TC variability was calculated as the SD of the residuals from the linear regression. We evaluated the association of intraindividual TC variability with incident CBI and worsening WMG between 2 MRI scans in primary analyses and with prevalent CBI number and WMG on the follow-up MRI scan in secondary analyses. Results- Among participants who were eligible for the study and free of clinical stroke before the follow-up MRI, 17.9% of 1098 had incident CBI, and 27.8% of 1351 had worsening WMG on the follow-up MRI. Mean, trend, and variability of TC were not associated with these outcomes. TC variability, independent of mean and trend, was significantly associated with the number of CBI (β=0.009 [95% CI, 0.003-0.016] P=0.004; N=1604) and was associated with WMG (β, 0.009 [95% CI, -0.0002 to 0.019] P=0.055; N=1602) on the follow-up MRI. Conclusions- Among older adults, TC variability was not associated with incident CBI or worsening WMG but was associated with the number of prevalent CBI on cranial MRI. More work is needed to validate and to clarify the mechanisms underlying such associations.

中文翻译：

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老年人的胆固醇变异性和颅磁共振成像发现：心血管健康研究。

背景与目的-血清胆固醇的变异性与平均值无关，与中风，颅脑磁共振成像（MRI）上的白质高信号以及其他心血管事件有关。我们试图在一项基于人群的纵向，队列研究中评估亚临床或隐性血管性脑损伤的总血清胆固醇（TC）变异性与颅内MRI发现之间的关系。方法-在《心血管健康研究》中，我们评估了颅内MRI上≥5年的隐匿性脑梗死（CBI）和白质分级（WMG）的个体化TC均值，趋势和变异性之间的关联。通过两次MRI扫描之间的4次年度TC测量，为每个研究参与者计算了平均TC。TC趋势计算为TC测量值线性回归的斜率，TC变异性通过线性回归计算为残差的SD。我们在主要分析中评估了两次个体化MRI扫描之间的个体化TC变异性与事件CBI和WMG恶化之间的关联，并在后续分析中评估了后续MRI扫描中普遍存在的CBI数和WMG。结果-在符合条件的研究中，在随访MRI之前没有临床卒中的参与者中，有107.9％的患者发生了CBI，而1351％的27.8％的患者在随访MRI上的WMG恶化。TC的均值，趋势和变异性与这些结果无关。TC变异性与平均值和趋势无关，与CBI数量显着相关（β= 0.009 [95％CI，0.003-0.016] P = 0.004; N = 1604），与WMG相关（β，0.009 [95％] CI，-0.0002至0.019] P = 0.055； N = 1602）。结论：在老年人中，TC变异性与CBI发生率或WMG恶化无关，但与颅MRI上普遍存在的CBI数目有关。需要更多的工作来验证和阐明这种关联的基础机制。