The ordinal regression analysis indicated that, after adjusting for age, hypertension, diabetes mellitus, atrial fibrillation, lacunar infarction, Cr, Hcy, and H-CRP, there was a lower risk of PVWMH in the patients with normal and moderately elevated serum Lp-PLA2 compared with those with significantly elevated serum Lp-PLA2 (normal Lp-PLA2: OR 0.258, 95% CI 0.119–0.520; moderate Lp-PLA2: OR 0.305, 95% CI 0.134–0.696) after adjusting for the confounding variables. This evidence concerns the gene PLA2G7 and diabetes mellitus.