Salt sensitivity and osmotic fragility are newly specified risk factors for age-related cerebral microangiopathy

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AIM/

To assess individual values of salt sensitivity and osmotic fragility on the patient’s erythrocytes and evaluate predictive ability of these parameters in the development of cerebral small vessel disease (CSVD).

MATERIAL AND METHODS

The study included 73 patients with CSVD (48 women, mean age 60.1±6.5 years) and 19 volunteers (14 women, mean age 56.9±5.4 years). Their erythrocytes were used for the measurement of salt-sensitivity by a modified salt blood test and of osmotic fragility by the classical osmotic fragility test. Binary logistic regression was used to assess the ability of salt-sensitivity and osmotic fragility to predict CSVD development. ROC analysis was used to find out the optimal threshold values of these predictors, their sensitivity and specificity.

RESULTS

An increase in salt sensitivity (cut-off: 8.5 mm/h; sensitivity 64%, specificity 74%) and osmotic fragility (cut-off: 0.62 u.a.; sensitivity 52%, specificity 90%) or their simultaneous use (p of the model <0.000001, cut-off 0.62; sensitivity 88%, specificity 68%) are the independent predictors of CSVD. An increase in salt sensitivity and osmotic fragility is also independently associated with the acceleration of severity of white matter hyperintensities according to Fazekas stages (p=0.019 and 0.004, respectively).

CONCLUSION

The possibility of prediction of CSVD according to an increase in salt sensitivity and osmotic fragility allows us to consider them as the risk factors of CSVD. The standardization of these tests for use in clinical practice is necessary to identify the risk group for CSVD and its individual prevention.

Keywords:

cerebral microangiopathy

cerebral small vessel disease

white matter hyperintensities

salt sensitivity

osmotic fragility

glycocalyx

Na+/K+-ATPas

Authors:

Dobrynina L.A.

Research Center of Neurology

ORCID: 0000-0001-9929-2725

Shabalina A.A.

Research Center of Neurology

SPIN RSCI: 9414-9068
Scopus AuthorID: 59097027100
ResearcherID: B-2504-2018
ORCID: 0000-0001-9604-7775

Shamtieva K.V.

Research Center of Neurology

Krotenkova M.V.

Research Center of Neurology

Kalashnikova L.A.

Research Center of Neurology

ORCID: 0000-0003-1142-0548

Received:

14.05.2020

Accepted:

09.06.2020

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