Metabolic syndrome and cerebral vasomotor reactivity
Article first published online: 28 JUN 2010
© 2010 The Author(s). European Journal of Neurology © 2010 EFNS
European Journal of Neurology
Volume 17, Issue 12, pages 1457–1462, December 2010
How to Cite
Giannopoulos, S., Boden-Albala, B., Choi, J. H., Carrera, E., Doyle, M., Perez, T. and Marshall, R. S. (2010), Metabolic syndrome and cerebral vasomotor reactivity. European Journal of Neurology, 17: 1457–1462. doi: 10.1111/j.1468-1331.2010.03087.x
- Issue published online: 18 NOV 2010
- Article first published online: 28 JUN 2010
- Received 7 December 2009 Accepted 26 March 2010
- cerebral vasomotor reactivity;
- CO2 reactivity;
- ischaemic stroke;
- metabolic syndrome
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 pCO2 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.