肥胖与缺血性脑血管病关系的研究进展

Advances in research on the relationship between obesity and ischemic cerebro⁃vascular disease

脑血管病是全球第二大死亡原因,常引起痴呆、瘫痪、失语等严重并发症,在所有脑血管病中缺血性脑血管病约占85%。随着我国老龄化进程加快,老年人口规模庞大,缺血性脑血管病的防治是我国面临的重大公共卫生问题。近年研究发现肥胖与缺血性脑血管病的关系密切,但仍存在争议,甚至有“肥胖悖论”学说。肥胖病人通常存在肠道菌群失调,体内脂质和激素稳态失衡,通过促进血小板聚集和血栓形成等机制参与动脉粥样硬化的形成;肥胖者体内长期处于低度慢性炎症和氧化应激状态,导致内皮功能障碍;另外,肥胖会导致脂肪组织内分泌功能紊乱,促炎脂肪因子的分泌增加,进而影响脑血管病的发病。本文就肥胖与缺血性脑血管病的相关性以及机制研究的文献进行论述,以期为缺血性脑血管病的防治提供一些参考依据。

Cerebrovascular diseases are the second leading cause of death in the world,often causing serious complications such as dementia,paralysis and aphasia.Ischemic cerebrovascular diseases account for about 85%of all cerebrovascular diseases.With the acceleration of the aging process in China and the large scale of the aged population,the prevention and treatment of ischemic cerebro⁃vascular disease has become a major public health problem in China.Recent studies have found a close relationship between obesity and ischemic cerebrovascular disease,but there are still controversies,and even the theory of"obesity paradox".Obese patients usually have intestinal microflora imbalance,imbalance of lipid and hormone homeostasis,and participate in the formation of atherosclerosis through promoting platelet aggregation and thrombosis.Obese patients are in a state of chronic inflammation and oxidative stress,which leads to endothelial dysfunction.Additionally,obesity can bring about endocrine functional disorders of adipose tissue,secretion of pro inflammatory adipokines increases,and then affect the incidence of cerebrovascular diseases.This article reviews the literatures on the correlation and mechanism between obesity and ischemic cerebrovascular diseases,in order to provide references for the prevention and treatment of ischemic cerebrovascular disease.