Overweight and obesity are well-known independent risk factors for stroke in the general population although uncertain in the case of the elderly, according to the obesity paradox. Little is known about underlying mechanisms. Our study aims to assess whether there is a relationship between excess body weight (measured as waist circumference) and poor cerebral hemodynamics (measured by transcranial Doppler parameters: basal, mean flow velocity (MFV), and dynamic, cerebrovascular reserve (CvR) in the right middle cerebral artery (RMCA)). A possible underlying molecular mechanism was analyzed via plasma leptin, adiponectin, TNF-α, IL-6, VCAM, and CRP levels. One hundred sixty-five subjects were included. Bivariate and multivariate regression showed a linear correlation between waist circumference and hemodynamics in RMCA, with clear gender effects: MFV (global NS, men β − 0.26 p < 0.01; women NS), CvR (global: β − 0.15 p < 0.01; men: β − 0.29 p < 0.01, women: β − 0.19 p < 0.09). For subjects above 65 years, there is no significant relationship between AbP and cerebral hemodynamics. In multivariate regression models, only leptin correlated independently with MFV in RMCA (β 7.24, p < 0.01) and CvR (β − 0.30, p < 0.01). In both cases, waist circumference remains significantly related to both parameters. There is an inverse linear correlation between excess body weight and cerebral hemodynamics, independent of other vascular risk factors and clearly influenced by gender. This relation disappears in the elderly population. Leptin might play a role in this relationship. Nevertheless, there must be another associated mechanism, not identified in this study.

根据肥胖悖论，超重和肥胖是一般人群中众所周知的中风的独立危险因素，尽管在老年人的情况下不确定。对潜在机制知之甚少。我们的研究旨在评估超重（以腰围测量）和脑血流动力学不良（通过经颅多普勒参数测量：基础血流速度 (MFV) 和动态脑血管储备 (CvR) 之间的关系）右侧大脑中动脉（RMCA））。通过血浆瘦素、脂联素、TNF-α、IL-6、VCAM 和 CRP 水平分析了可能的潜在分子机制。包括一百六十五名受试者。双变量和多变量回归显示 RMCA 中腰围和血流动力学之间呈线性相关，具有明显的性别影响：p  < 0.01；女性 NS)、CvR（全球：β - 0.15 p  < 0.01；男性：β - 0.29 p  < 0.01，女性：β - 0.19 p  < 0.09）。对于 65 岁以上的受试者，AbP 与脑血流动力学之间没有显着关系。在多元回归模型中，只有瘦素与 RMCA (β 7.24, p  < 0.01) 和 CvR (β − 0.30, p < 0.01)。在这两种情况下，腰围仍然与这两个参数显着相关。超重与脑血流动力学呈负线性相关，独立于其他血管危险因素，且明显受性别影响。这种关系在老年人口中消失了。瘦素可能在这种关系中发挥作用。然而，必须有另一种相关机制，在本研究中未确定。