Associations of clinical obesity with arterial stiffness and cerebral small vessel disease: a population-based study

Based on the comprehensive indicator of clinical obesity, this study investigates its association with arterial stiffness and cerebral small vessel disease (cSVD).

This cross-sectional study analyzed 2,011 adults from the Multimodal Imaging Study based on the Kailuan Cohort. From 2021 to 2024, participants underwent Brain magnetic resonance imaging scans and obesity assessments. We used logistic regression models to evaluate associations between clinical obesity, arterial stiffness, and cSVD, adjusting for age, sex, smoking history, drinking history, physical activity, glucose-lowering medication, lipid-lowering medication, homocysteine, C-reactive protein, and low-density lipoprotein cholesterolMediation analysis tested whether arterial stiffness mediated the obesity-cSVD relationship.

A total of 2,011 participants (49.8% male, mean age 53.7 ± 12.2 years) were included. Clinical obesity was significantly associated with a higher total burden of cSVD, and the strength of its association with specific imaging markers decreased in the following order: perivascular spaces (PVS), lacunar infarcts, white matter hyperintensities (WMH), and cerebral microbleeds (CMB). Arterial stiffness significantly mediated the association between clinical obesity and cSVD.

Clinical obesity was significantly associated with cSVD, with its association varying across specific imaging markers. Arterial stiffness mediates this relationship, suggesting that targeting obesity and arterial stiffness may help prevent subclinical cerebrovascular damage.