Study on the relationship between the total burden of arteriosclerotic cerebral small vessel disease and non⁃high⁃density lipoprotein cholesterol

Objective A preliminary study on the correlation between serum non⁃high⁃density lipoprotein cholesterol (non⁃HDL⁃C) and the severity of total burden of cerebral small vessel disease (CSVD) , and influencing factors of the severity of CSVD total burden were screened. Methods A total of 166 patients diagnosed with arteriosclerotic CSVD (aCSVD) admitted to Cangzhou Central Hospital from December 2024 to February 2025 were retrospectively enrolled. We evaluated white matter hyperintensity (WMH), lacunar infarct (LACI), cerebral microbleeds (CMBs) and enlarged perivascular space (EPVS) based on the cranial MRI to calculate the CSVD total burden score. Spearman rank correlation analysis was performed to analyse the relationship between non⁃HDL⁃C and CSVD total burden. Univariate and multivariate Logistic regression analyses were further used to identify influencing factors for the severity of CSVD total burden. Results According to the CSVD total burden score, the patients were divided into the mild total burden (0-1 point) group (n=79) and the moderate and severe total burden (2-4 points) group (n = 87). There was a positive correlation between non⁃HDL⁃C level and CSVD total burden score (rs=0.184, P = 0.018). Logistic regression analysis revealed that older age (OR = 1.046, 95%CI: 1.001-1.094; P = 0.045), increased homocysteine (OR = 1.057, 95%CI: 1.003-1.115; P = 0.040) and increased non⁃HDL⁃C (OR = 1.376, 95%CI: 1.026-1.848; P = 0.033) were risk factors for the moderate and severe CSVD total burden. Conclusions Increased non⁃HDL⁃C is a risk factor for the moderate and severe CSVD total burden, or it may potentially serve as an target of intervention for aCSVD.