Metabolic syndrome and cerebral vasomotor reactivity
Metabolic syndrome and cerebral vasomotor reactivity
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DOI：
10.1111/j.1468-1331.2010.03087.x
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发表时间：
2010-12-01
影响因子：
5.1
通讯作者：
Marshall, R. S.
中科院分区：
文献类型：
--
作者：
Giannopoulos, S.;Boden-Albala, B.;Marshall, R. S.
背景和目的：代谢综合征被认为是脑卒中和短暂性脑缺血发作的危险因素。病理生理机制之一可能是内皮功能受损。因此，我们假设，脑血管反应性将减少代谢综合征患者相比，没有metabolic syndrome.Methods：在这项回顾性分析中，83例连续患者（年龄59.19 +/- 15.98; 33名妇女）进行了多普勒检查颈动脉疾病，包括双半球血管反应性评估，采用经颅多普勒监测。血管反应性数据来自没有或轻度颈动脉狭窄（< 40%）的半球。脑血管反应性计算为麻醉面罩吸入5%CO2 2 2 min内每mmHg pCO（2）平均流速增加的百分比（如果>= 2%/mmHg，则为正常）。单变量和多变量线性回归模型被用来确定因素，包括代谢综合征，是独立相关的病理vascularreactivity.Results：调整后的对侧颈动脉狭窄和同侧中风的多变量模型中的存在，代谢综合征是独立相关的较低的vascularreactivityvalues（2.27 +/-1.24%vs.2.68 +/- 1.37; ss =-0.258，P = 0.033）。在这个模型中，有脑血管反应性与年龄，性别，种族，心脏病，目前他汀类药物治疗，或小血管diseases.Conclusions：我们的研究结果表明，受损的脑血管反应性可能是代谢综合征，综合征影响一个显着的和不断增长的人口比例的患者中风的介质。需要进行一项前瞻性纵向研究来研究代谢综合征对脑血流动力学的影响。
Background and purpose:Metabolic syndrome has been proposed as a risk factor for stroke and transient ischaemic attack. One pathophysiological mechanism could be impairment of endothelial function. Thus, we hypothesized that cerebral vasomotor reactivity would be decreased in patients with metabolic syndrome, compared to patients without metabolic syndrome.Methods:In this retrospective analysis, 83 consecutive patients (aged 59.19 +/- 15.98; 33 women) underwent Doppler examination for carotid artery disease including bi-hemispherical vasomotor reactivity assessment using transcranial Doppler monitoring. Vasomotor reactivity data were analyzed from the hemisphere with no or low-grade carotid stenosis (< 40%). Cerebral vasomotor reactivity was calculated as percent increase in mean flow velocity per mmHg pCO(2) during 2 min of 5% CO2 inhalation delivered by anesthesia mask (normal if >= 2%/mmHg). Univariate and multivariable linear regression models were used to determine factors, including metabolic syndrome, that were independently associated with pathologic vasomotor reactivity.Results:After adjusting for the presence of contralateral carotid stenosis and ipsilateral stroke in the multivariable model, metabolic syndrome was independently associated with lower vasomotor reactivity values (2.27 +/- 1.24% vs. 2.68 +/- 1.37; ss = -0.258, P = 0.033). In this model, there was no association of cerebral vasomotor reactivity with age, gender, race, cardiac disease, current statin therapy, or small vessel disease.Conclusions:Our findings suggest that impaired cerebral vasomotor reactivity may be a mediator of stroke in patients with metabolic syndrome, a syndrome affecting a significant and growing proportion of the population. A prospective longitudinal study is warranted to study the cerebral haemodynamic effect of metabolic syndrome.