Visceral obesity is associated with white matter hyperintensity and lacunar infarct

Abstract

VAT has a significant association with cerebral small vessel disease, which was defined as WMH or lacunar infarct. Visceral obesity can be a potential therapeutic target for the prevention of cerebral small vessel disease.

Visceral obesity relates to deep white matter hyperintensities via inflammation

“…42 These latter mechanisms could have contributed to our results, given that visceral obesity is linked to higher circulating IL6 and high-sensitivity CRP, indicating lowgrade systemic inflammation. 9,44 Our study supports these findings and indicates, by means of mediation path analyses, that visceral obesity increases the development of dWMHs through increases in inflammatory activity, indexed by circulating IL6. 9,44 Our study supports these findings and indicates, by means of mediation path analyses, that visceral obesity increases the development of dWMHs through increases in inflammatory activity, indexed by circulating IL6.…”

“…2,3 A major risk factor for WMH beyond older age is hypertension, 4 in particular, higher systolic blood pressure. 5 Moreover, WMH have been linked to smoking, 6 type 2 diabetes, 7 and recently also to obesity, 8,9 a growing challenge to public health in today's societies. 10 Longitudinal cohort data indicate that WMH load is associated with higher risk of cognitive decline, dementia, and stroke.…”

Non‐obese fatty liver disease is associated with lacunar infarct

“…One neuroradiology board‐certified expert (HS) who was blinded to patients' clinical information reviewed all brain MRI for small vessel disease, lacunar infarct, and cerebrovascular stenosis. Lacunar infarct was defined as a small lesion (< 20 mm) in the white matter or subcortical grey matter including either (i) hyperintensity on T2‐weighted images with central low signal intensity and perilesional gliosis on FLAIR images or (ii) hyperintensity on both FLAIR and T2‐weighted images along the perforating arteries . To investigate the association between fatty liver disease and white matter hyperintensity in sensitivity analysis, we utilized the cohort of white matter hyperintensity, which was defined in our previous study …”

“…This small, deep infarct is common, accounting for one‐quarter of cerebral infarctions, and typically clinically silent; less frequently, lacunar infarct is symptomatic . Although lacunar infarcts show favourable clinical outcomes during short‐term follow‐ups, with relatively low early mortality and reduced functional disturbance on hospital discharge, they are a recognized risk factor for future cognitive impairment, dementia, stroke and death during long‐term follow‐ups . Old age and hypertension are well‐known major risk factors for lacunar infarct.…”

“…1,3 Although lacunar infarcts show favourable clinical outcomes during short-term follow-ups, with relatively low early mortality and reduced functional disturbance on hospital discharge, they are a recognized risk factor for future cognitive impairment, dementia, stroke and death during long-term follow-ups. 3,4 Old age and hypertension are well-known Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CI, confidence interval; FLAIR, fluid-attenuated inversion recovery; MRI, magnetic resonance imaging; NFS, non-alcoholic fatty liver disease fibrosis score; OR, odds ratio; US, ultrasonography.…”