title: Relationship of obesity and insulin resistance with the cerebrovascular reactivity: a case control study.
abstract: BACKGROUND
  Obesity is associated with increased risk for stroke. The breath-holding index (BHI) is a measure of vasomotor reactivity of the brain which can be measured with the transcranial Doppler (TCD). We aim to evaluate obesity as an independent factor for altered cerebrovascular reactivity.
  
  
  METHODS
  Cerebrovascular hemodynamics (mean flow velocities MFV, pulsatility index, PI, resistance index, RI, and BHI) was determined in 85 non-obese (Body Mass Index, BMI ≤27 kg/m2) and 85 obese subjects (BMI ≥35 kg/m2) without diabetes mellitus and hypertension. Anthropometric and metabolic variables, and scores to detect risk for obstructive sleep apnea (OSA) were analyzed for their association with the cerebrovascular reactivity.
  
  
  RESULTS
  The BHI was significantly lower in subjects with obesity according to BMI and in subjects with abdominal obesity, but the PI and RI were not different between groups. There was a linear association between the BMI, the HOMA-IR, the Matsuda index, the waist circumference, and the neck circumference, with the cerebrovascular reactivity. After adjusting for insulin resistance, neck circumference, and abdominal circumference, obesity according to BMI was negatively correlated with the cerebrovascular reactivity.
  
  
  CONCLUSIONS
  We found a diminished vasomotor reactivity in individuals with obesity which was not explained by the presence of insulin resistance.
authors.affiliation: Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Obesity and Eating Disorders Clinic, SS, Vasco de Quiroga No 15 Col Sección XVI, PC 14000 Mexico City, Mexico. chelorf76@yahoo.com.
authors.forename: Marcela
authors.initials: M
authors.lastname: Rodríguez-Flores
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-García
authors.forename: Claudia Vanessa
authors.initials: CV
authors.lastname: Cano-Nigenda
authors.forename: Carlos
authors.initials: C
authors.lastname: Cantú-Brito
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D014666:Vasomotor System / Q000502:physiology*; D055105:Waist Circumference / Q000502:physiology