Letra Liliana, Sena Cristina
Institute of Physiology, Institute for Biomedical Imaging and Life Sciences-IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Neurology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
Adv Neurobiol. 2017;19:163-189. doi: 10.1007/978-3-319-63260-5_7.
Despite the well-known global impact of overweight and obesity in the incidence of cerebrovascular disease, many aspects of this association are still inconsistently defined. In this chapter we aim to present a critical review on the links between obesity and both ischemic and hemorrhagic stroke and discuss its influence on functional outcomes, survival, and current treatments to acute and chronic stroke. The role of cerebrovascular endothelial function and respective modulation is also described as well as its laboratory and clinical assessment. In this context, the major contributing mechanisms underlying obesity-induced cerebral endothelial function (adipokine secretion, insulin resistance, inflammation, and hypertension) are discussed. A special emphasis is given to the participation of adipokines in the pathophysiology of stroke, namely adiponectin, leptin, resistin, apelin, and visfatin.
尽管超重和肥胖对脑血管疾病发病率的全球影响广为人知，但这种关联的许多方面仍未得到一致定义。在本章中，我们旨在对肥胖与缺血性和出血性中风之间的联系进行批判性综述，并讨论其对功能结局、生存率以及急性和慢性中风当前治疗方法的影响。还描述了脑血管内皮功能的作用及其相应调节，以及其实验室和临床评估。在此背景下，讨论了肥胖诱导脑内皮功能的主要促成机制（脂肪因子分泌、胰岛素抵抗、炎症和高血压）。特别强调了脂肪因子在中风病理生理学中的参与，即脂联素、瘦素、抵抗素、Apelin和内脂素。
