Hypercholesterolemia is associated with a lower risk of cerebral ischemic small vessel disease detected on brain checkups

ObjectiveSeveral studies have reported an association between low cholesterol levels and cerebral small vessel disease (SVD). In this study, we examined whether serum total cholesterol was associated with SVD, including lacunar infarctions and white matter hyperintensity, detected by magnetic resonance imaging (MRI), in participants who had a checkup of the brain.MethodsWe retrospectively investigated 6143 participants aged 40 and over who visited a hospital for a brain checkup in a cross-sectional design. We performed logistic regression analysis to examine the association between total cholesterol and SVD.ResultsSVD was observed in 1456 participants (24%). Adjusting for sex, age, body mass index, hypertension, hypertriglyceridemia, and diabetes, a total cholesterol ≥ 225 mg/dL (the highest quartile) was significantly associated with not having SVD compared with a total cholesterol < 178 mg/dL (the lowest quartile; odds ratio [OR], 0.708; 95% confidence interval [CI], 0.581–0.863). Participants with a total cholesterol of 200–225 mg/dL (the third quartile) tended to have a reduced risk of SVD (OR, 0.832; 95%CI, 0.689–1.005).ConclusionHypercholesterolemia was significantly associated with a lower risk of SVD, detected by MRI, in participants undergoing a brain checkup, after adjusting for potential confounding factors, such as age and hypertension.