Mean platelet volume (MPV) is associated with leukoaraiosis in the apparently healthy elderly Seong-Jin Kang a,1 , Byoung-Jin Park b,1 , Jae-Yong Shim a , Hye-Ree Lee a , Ji-Man Hong c , Yong-Jae Lee a, * a Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea b Department of Medicine, Yonsei University Graduate School, Seoul, Republic of Korea c Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea 1. Introduction The term leukoaraiosis describes a pattern of diffuse white matter abnormalities on brain MRI scans, which are often found incidentally in asymptomatic individuals (Vernooij et al., 2007). Leukoaraiosis has long been regarded as a benign manifestation with scarce or no clinical significance. However, it is now considered a link between inflammation and thrombosis in cardiovascular disease (CVD) (Inzitari et al., 1995) and various geriatric syndromes including cognitive impairment (Vermeer et al., 2003), depressive mood (Greenwald et al., 1996), balance and gait speed (Starr et al., 2003). Although the developing mechanism of leukoaraiosis remains unclear, an ischemic cerebral arteriolar damage has been suggested as a possible underlying cause (Pantoni and Garcia, 1997). Previous pathological studies have shown that leukoaraiosis is associated with CVD risk factors and cerebral microangiopathy (Fazekas et al., 1993; Jagust et al., 2008). Thus, it would be important to pay attention to leukoaraiosis because of its potential risk of ischemic stroke, vascular dementia, and Alzheimer’s disease (Wiszniewska et al., 2000; Erkinjuntti et al., 2002; Thal et al., 2003; Gurol et al., 2006). MPV is widely used as a measure of platelet size and it has been known to be a marker of platelet activity. Epidemiologic evidence suggests that MPV is linked to cardiometabolic risk factors such as obesity (Arslan and Makay, 2010), hypercholesterolemia (Pathan- sali et al., 2001), diabetes (Papanas et al., 2004), hypertension (Nadar et al., 2004), and arterial stiffness (Wang et al., 2011). Moreover, several studies have shown that elevated MPV is associated with the risk of CVD such as myocardial infarction (Chu et al., 2010), stroke (Muscari et al., 2009), and peripheral artery disease (Berger et al., 2010). In the light of these findings, we can infer that there is a positive association between MPV and leukoaraiosis. However, nothing is known on the relationship between MPV and leukoaraiosis. Therefore, this study aimed to examine the association between MPV and leukoaraiosis in the apparently healthy elderly. Archives of Gerontology and Geriatrics 54 (2012) e118–e121 ARTICLE INFO Article history: Received 23 August 2011 Received in revised form 19 October 2011 Accepted 20 October 2011 Available online 12 November 2011 Keywords: MPV Leukoaraiosis Cerebral microangiopathy ABSTRACT Leukoaraiosis refers to diffuse white matter abnormalities on MR brain scans, which have been suggested to be associated with cerebral microangiopathy and geriatric syndromes such as cognitive impairment, depressive mood and gait disturbance. MPV is a simple indicator of platelet size and has been known to be a marker of platelet activity. MPV is now considered a link between inflammation and thrombosis in multiple cardiovascular and cerebrovascular disorders including hypertension, peripheral artery disease, and stroke. This cross-sectional study aims to evaluate the association between MPV and leukoaraiosis for 223 healthy elderly subjects (142 men, 81 women; mean age 66.0  5.2 years) in a health examination program including brain magnetic resonance imaging (MRI) scans. The overall prevalence rate of leukoaraiosis was 15.3%. The mean MPV was significantly higher in the leukoaraiosis group than control group: 8.4  0.8 and 8.1  1.0, respectively (p = 0.036). A higher value of MPV was independently associated with an increased risk of leukoaraiosis. In the multivariate logistic analysis, the odds ratio (OR) (95% confidence interval (CI)) for leukoaraiosis was 1.61 (1.02–2.53) with 1 fL of MPV increment after adjusting for confounding variables. In conclusion, MPV was found to be independently and positively associated with leukoaraiosis. This finding indicates that MPV values may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting. ß 2011 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Department of Family Medicine, Yonsei University College of Medicine, 225 Geumhakno, Cheoin-gu, Yongin-si, Gyeonggi-do, Republic of Korea. Tel.: +82 31 331 8710; fax: +82 31 331 5551. E-mail address: ukyjhome@yuhs.ac (Y.-J. Lee). 1 Both the authors contributed equally to this work. Contents lists available at SciVerse ScienceDirect Archives of Gerontology and Geriatrics journal homepage: www.elsevier.com/locate/archger 0167-4943/$ – see front matter ß 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.archger.2011.10.010