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Hathaway I, Momodu OE, Williams DM, Beamish AJ, Barry J, Stephens JW. Changes in Cognitive Function Following Bariatric Surgery: An Updated Systematic Review. Obes Surg 2024; 34:2216-2226. [PMID: 38668820 DOI: 10.1007/s11695-024-07235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/27/2024]
Abstract
Since a previous systematic review published in 2016, there have been further studies investigating the association of changes in cognitive function following bariatric surgery. All studies since the original review that reported at least one element of cognitive function before and after bariatric surgery were eligible. A total of 137 additional studies were identified; 13 were included in addition to the 18 studies previously. Almost all studies reported improvements in at least one domain. Most revealed improvements were limited to a few domains and were not universal. Further findings investigated cognitive function improvement in relation to procedure choice, and mental health or quality of life post-surgery. Further high-powered studies are still necessary, but these findings support the impact of bariatric surgery on cognitive function in obesity.
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Affiliation(s)
- Isaac Hathaway
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK.
| | | | - David M Williams
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Andrew J Beamish
- Welsh Institute of Metabolic & Obesity Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Jonathan Barry
- Welsh Institute of Metabolic & Obesity Surgery, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
| | - Jeffrey W Stephens
- Diabetes Centre, Morriston Hospital, Swansea Bay University Health Board, Swansea, SA6 6NL, UK
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, SA2 8QA, UK
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Tao B, Zhang P. Response to Dr. Buchwald. Obes Surg 2024; 34:1947-1948. [PMID: 38584214 DOI: 10.1007/s11695-024-07218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024]
Affiliation(s)
- Boyu Tao
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Peng Zhang
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Pino JMV, Silva VF, Campos RMS, Mônico-Neto M, de Araujo KA, Seva DC, Kato MY, Galvão TD, Bitterncourt LRA, Tufik S, Lee KS. Impact of Bariatric Surgery on Circulating Metabolites and Cognitive Performance. Obes Surg 2024; 34:1102-1112. [PMID: 38363496 DOI: 10.1007/s11695-024-07096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Bariatric surgery is an effective intervention to reduce obesity and improve associated comorbidities. However, its effects on cognitive function are still the subject of debate. Given that the bioavailability of circulating metabolites can influence brain metabolism and cognitive performance, we aimed to assess the effects of bariatric surgery on plasma metabolic profiles and cognitive performance. METHODS We recruited 26 women undergoing gastric bypass surgery. We conducted anthropometric assessments and collected plasma samples for metabolomic analysis. A set of 4 cognitive tests were used to evaluate cognitive performance. Participants were reevaluated 1 year post-surgery. RESULTS After surgery, attention capacity and executive function were improved, while immediate memory had deteriorated. Regarding metabolic profile, reduction of beta-tocopherol and increase of serine, glutamic acid, butanoic acid, and glycolic acid were observed. To better understand the relationship between cognitive function and metabolites, a cluster analysis was conducted to identify more homogeneous subgroups based on the cognitive performance. We identified cluster 1, which did not show changes in cognitive performance after surgery, and cluster 2, which showed improved attention and executive function, but reduced performance in the immediate memory test. Thus, cluster 2 was more homogeneous group that replicated the results of non-clustered subjects. Analysis of the metabolic profile of cluster 2 confirmed serine, glutamic acid, and glycolic acid as potential metabolites associated with cognitive performance. CONCLUSIONS Metabolites identified in this study have potential for biomarkers and alternative therapeutic target to prevent obesity-related cognitive decline. KEY POINTS • Attention capacity and executive function were improved 12 months post bariatric surgery. • Immediate memory was worsened 12 months post bariatric surgery. • Serine, glutamic acid, and glycolic acid are potential metabolites linked to the alteration of cognitive performance.
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Affiliation(s)
- Jessica M V Pino
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Edifício de Pesquisa II, Rua Pedro de Toledo, 669, 8º Andar, CEP, São Paulo, 04039-032, Brazil
| | - Vitória F Silva
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Edifício de Pesquisa II, Rua Pedro de Toledo, 669, 8º Andar, CEP, São Paulo, 04039-032, Brazil
| | - Raquel M S Campos
- Post Graduated Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Santos, Brazil
| | - Marcos Mônico-Neto
- Post Graduated Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Santos, Brazil
- BariMais Clinic-Integrated Medicine, São Paulo, Brazil
| | - Kaique A de Araujo
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Edifício de Pesquisa II, Rua Pedro de Toledo, 669, 8º Andar, CEP, São Paulo, 04039-032, Brazil
| | - Danielle C Seva
- Post Graduated Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Santos, Brazil
| | - Melissa Y Kato
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Edifício de Pesquisa II, Rua Pedro de Toledo, 669, 8º Andar, CEP, São Paulo, 04039-032, Brazil
| | | | - Lia R A Bitterncourt
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kil S Lee
- Department of Biochemistry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Edifício de Pesquisa II, Rua Pedro de Toledo, 669, 8º Andar, CEP, São Paulo, 04039-032, Brazil.
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Järvholm K, Gronowitz E, Janson A, Peltonen M, Sjögren L, Beamish AJ, Dahlgren J, Mårtensson J, Olbers T. Cognitive functioning in adolescents with severe obesity undergoing bariatric surgery or intensive non-surgical treatment in Sweden (AMOS2): a multicentre, open-label, randomised controlled trial. EClinicalMedicine 2024; 70:102505. [PMID: 38685922 PMCID: PMC11056597 DOI: 10.1016/j.eclinm.2024.102505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/01/2024] [Accepted: 02/15/2024] [Indexed: 05/02/2024] Open
Abstract
Background Severe obesity during childhood is associated with cognitive deficits. Studies in adults have suggested improvements in executive functioning and memory after bariatric surgery. Our aim was to explore changes in cognitive function in adolescents over two years after bariatric surgery or intensive non-surgical treatment. Methods The Adolescent Morbid Obesity Surgery 2 (AMOS2) is a multicentre, open-label, randomised controlled trial in which adolescents (aged 13-16 years) with severe obesity (defined as body mass index (BMI) ≥35 kg/m2) at three specialised obesity centres in Sweden, were randomly assigned to receive bariatric surgery or intensive non-surgical treatment. Herein we report the results of the prespecified exploratory endpoint of change in cognitive functioning. Inclusion in AMOS2 required Tanner pubertal stage ≥3, previous participation in lifestyle obesity treatment for at least one year, and passed assessment form a paediatrician and a paediatric psychologist. Adolescents with severe intellectual disability or other severe, pervasive developmental disorder were excluded. Participants underwent baseline assessment of general intellectual ability, executive functioning, and memory before randomisation. Tests were administrated by clinical psychologists and repeated at one- and two-year follow-up timepoints. Differences in means between groups during follow-up are provided with confidence intervals. The trial is registered at ClinicalTrials.gov, NCT02378259. Findings Between October 28 2015 and June 7 2017, 46 adolescents (74% girls), with a mean age of 15.8 (±0.92) years and a mean BMI of 42.8 (±5.4) kg/m2, were included and randomised (23 to bariatric surgery and 23 to intensive non-surgical treatment). At baseline 23/46 (50%) of the adolescents had general intellectual functioning classified as borderline or below. For 15/18 (83%) aspects of cognitive functioning, no significant differences in change over two years were identified between groups; Immediate (average difference during follow-up 1.0 [95% CI: -2.6 to 4.6]) and Delayed (0.5 [95% CI: -0.6 to 1.6]) Verbal Recall, Category Fluency (1.1 [95% CI: -1.6 to 3.8]) and Switching (1.5 [95% CI: -0.0 to 2.9]), Number (-6.0 [95% CI: -12.3 to 0.3]) and Letter (0.1 [95% CI: -5.2 to 5.3]) Sequencing, Number-Letter Switching (-10.3 [95% CI: -26.4 to 5.8]), Motor Speed (-8.3 [95% CI: -17.5 to 0.9]), Colour Naming (-1.9 [95% CI: -4.2 to 0.3]), Inhibition (-3.6 [95% CI: -9.6 to 2.5]), Inhibition Switching (-6.7 [95% CI: -15.3 to 1.9]), Mazes (-0.5 [95% CI: -4.9 to 3.9]), Digit Span Forward (0.1 [95% CI: -0.6 to 0.9 ]) and Backward (0.6 [95% CI: -0.4 to 1.6 ]), and Estimated IQ (0.4 [95% CI: -3.9 to 4.8]; all p > 0.05). Three sub-tests assessing fundamental cognitive skills improved more over two years in operated adolescents than in intensive non-surgical treatment; Letter Fluency (average difference during follow-up 3.8 [95% CI: 0.1-7.5]; p = 0.046), Visual Scanning (-6.5 [95% CI: -11.6 to -1.5]; p = 0.011), and Word Reading (-1.9 [95% CI: -3.3 to -0.4]; p = 0.011). Interpretation In contrast to non-randomised studies in adults, we could not demonstrate an association of bariatric surgery and its accompanying significant weight loss with overall greater improvement in executive functions and memory in adolescents over two years compared with a non-surgical group without weight loss. However, lack of statistical power is a potential limitation. The clinical relevance of greater improvements in basic cognitive skills needs to be explored. Funding Sweden's innovation agency (VINNOVA), Swedish Research Council, Joanna Cocozza foundation for paediatric research, The Skane University Hospital Psychology Research and Development Grant, Tore Nilsson's Foundation, SUS Foundations and Donations, and Mary von Sydow's Foundation.
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Affiliation(s)
- Kajsa Järvholm
- Department of Psychology, Lund University, Lund, Sweden
- Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden
| | - Eva Gronowitz
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annika Janson
- National Childhood Obesity Centre, Karolinska University Hospital, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Lovisa Sjögren
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Regional Obesity Center, Gothenburg, Sweden
| | - Andrew J. Beamish
- Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, Swansea, United Kingdom
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Jovanna Dahlgren
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Regional Obesity Center, Gothenburg, Sweden
| | - Johan Mårtensson
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Torsten Olbers
- Department of Biomedical and Clinical Sciences and Wallenberg Center for Molecular Medicine, Linköping University, Linköping, Sweden
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Tao B, Tian P, Hao Z, Qi Z, Zhang J, Liu J, Liu J, Li M, Zhang Z, Zhang P. Bariatric Surgery Improves Cognition Function in the Patients with Obesity: A Meta-Analysis. Obes Surg 2024; 34:1004-1017. [PMID: 38342815 DOI: 10.1007/s11695-024-07086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
Obesity and related comorbidities have negative impacts on cognitive function. Weight loss seems to be associated with the improvement of cognitive function and the recovery of brain structure, but the underlying mechanism is not clear. This meta-analysis aimed to explore the status of cognitive function including memory, executive function, attention and language ability in patients with obesity, and to further investigate whether bariatric surgery can improve overall cognitive function in these patients. A total of 11 literatures with 728 subjects were included after retrieval and exclusion. The meta-analysis showed significant improvements in memory, attention and executive function scores after undergoing bariatric surgery in the patients with obesity. However, there was no significant improvement in language ability.
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Affiliation(s)
- Boyu Tao
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Peirong Tian
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Zhen Hao
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Zitian Qi
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jingyu Zhang
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jia Liu
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Jingli Liu
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Mengyi Li
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Zhongtao Zhang
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China
| | - Peng Zhang
- Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
- National Clinical Research Center for Digestive Diseases, Beijing, 100050, China.
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Stańczykiewicz B, Łuc M, Banach M, Zabłocka A. Cystatins: unravelling the biological implications for neuroprotection. Arch Med Sci 2023; 20:157-166. [PMID: 38414464 PMCID: PMC10895963 DOI: 10.5114/aoms/171706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/31/2023] [Indexed: 02/29/2024] Open
Abstract
Cystatins, a family of proteins known for their inhibitory role against cysteine proteases, have garnered significant attention in the field of neurodegeneration. Numerous genetic, experimental, and clinical studies concerning cystatin C suggest it plays an important role in the course of neurodegenerative diseases. Its beneficial effects are associated with cysteine protease inhibition, impact on β-amyloid aggregation, as well as regulation of cell proliferation, autophagy, and apoptosis. Cystatin isolated from chicken egg white, called ovocystatin, has been widely used in medical and pharmaceutical research due to its structural and biological similarities to human cystatin C. This article focuses on the potential use of cystatins, with special emphasis on easily obtained ovocystatin, in the treatment of neurodegenerative diseases, such as dementia. The current evidence on cystatin use has shed light on its mechanisms of action and therapeutic implications for neuroprotection and maintenance of cognitive functions.
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Affiliation(s)
- Bartłomiej Stańczykiewicz
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Łuc
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Zabłocka
- Department of Microbiology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Nozari Y, Park C, Brietzke E, Iacobucci M, Gill H, McIntyre RS. Correlation between improved leptin signaling and cognitive function post bariatric surgery. J Affect Disord 2023; 326:225-231. [PMID: 36736790 DOI: 10.1016/j.jad.2023.01.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/23/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
Determining whether changes in leptin signaling plays a role in the improvement of cognitive function post-bariatric surgery may aid in the understanding and development of novel therapeutic approaches targeting cognitive dysfunction through the greater understanding of processes connecting obesity and brain health. Several studies have explored the effects of cognition post bariatric surgery, and others have studied leptin and its changes post surgery. However the amalgamation of the effects of leptin signaling in relation to cognition post bariatric surgery have yet to be considered as key tools in the understanding of cognitive dysfunction in obese subjects with leptin resistance or insensitivity. This review serves to highlight the potential correlations, to further elucidate the effect of improved leptin signaling on cognition post bariatric surgery, and to propose a direct cause for the improvement of cognitive function via the amelioration of the leptin Janus kinase/Signal transducer and activator of transcription (JAK/STAT) signaling pathway as a result of the reversal of inflammatory processes involved in diseased individuals.
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Affiliation(s)
- Y Nozari
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada; University of Toronto HBSc, Toronto, ON, Canada.
| | - C Park
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada; University of Toronto MSc, Toronto, ON, Canada
| | - E Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada; Centre for Neuroscience Studies (CNS), Queen's University, Kingston, ON, Canada
| | - M Iacobucci
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada; University of Toronto HBSc, Toronto, ON, Canada
| | - H Gill
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - R S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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Reynolds EL, Votruba KL, Watanabe M, Banerjee M, Elafros MA, Chant E, Villegas-Umana E, Giordani B, Feldman EL, Callaghan BC. The Effect of Surgical Weight Loss on Cognition in Individuals with Class II/III Obesity. J Nutr Health Aging 2023; 27:1153-1161. [PMID: 38151865 PMCID: PMC11100299 DOI: 10.1007/s12603-023-2047-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/10/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Obesity is a global epidemic and is associated with cognitive impairment and dementia. It remains unknown whether weight loss interventions, such as bariatric surgery, can mitigate cognitive impairment. OBJECTIVES We aimed to determine the effect of surgical weight loss on cognition in individuals with class II/III obesity. DESIGN We performed a prospective cohort study of participants who underwent bariatric surgery. At baseline and two years following surgery, participants completed metabolic risk factor and neuropsychological assessments. SETTING Participants were enrolled from an academic suburban bariatric surgery clinic. PARTICIPANTS There were 113 participants who completed baseline assessments and 87 completed two-year follow-up assessments (66 in-person and 21 virtual) after bariatric surgery. The mean (SD) age was 46.8 (12.5) years and 64 (73.6%) were female. INTERVENTION Bariatric surgery. There were 77 (88.5%) participants that underwent sleeve gastrectomy and 10 (11.5%) that underwent gastric bypass surgery. MEASUREMENTS Cognition was assessed using the NIH toolbox cognitive battery (NIHTB-CB) and the Rey Auditory Verbal Learning Test (AVLT). The primary outcome was the change in NIHTB-CB fluid composite score before and after surgery. RESULTS The primary outcome, NIHTB-CB composite score, was stable following bariatric surgery (-0.4 (13.9), p=0.81,n=66). Among secondary outcomes, the NIHTB-CB dimensional card sorting test (executive function assessment), improved (+6.5 (19.9),p=0.01,n=66) while the Rey AVLT delayed recall test (memory assessment) declined (-0.24 (0.83),p=0.01,n=87) following surgery. Improvements to metabolic risk factors and diabetes complications were not associated with improvements to NIHTB-CB composite score. The other 4 NIHTB-CB subtests and Rey AVLT assessments of auditory learning and recognition were stable at follow-up. CONCLUSIONS Following bariatric surgery, the age-adjusted composite cognitive outcome did not change, but an executive subtest score improved. These results suggest that bariatric surgery may mitigate the natural history of cognitive decline in individuals with obesity, which is expected to be faster than normal aging, but confirmatory randomized controlled trials are needed. The decline in delayed recall also warrants further studies to determine potential differential effects on cognitive subtests.
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Affiliation(s)
- E L Reynolds
- Brian Callaghan, 109 Zina Pitcher Place, 4021 BSRB, Ann Arbor, MI 48104, 734-764-7205 office, 734-763-7275 fax,
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Li CM, Song JR, Zhao J, Wang CF, Zhang CS, Wang HD, Zhang Q, Liu DF, Ma ZY, Yuan JH, Dong J. The Effects of Bariatric Surgery on Cognition in Patients with Obesity: a Systematic Review and Meta-Analysis. Surg Obes Relat Dis 2022; 18:1323-1338. [DOI: 10.1016/j.soard.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/08/2022] [Accepted: 07/16/2022] [Indexed: 11/29/2022]
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Wood AC, Momin SR, Senn MK, Bridgett DJ. Context Matters: Preliminary Evidence That the Association between Positive Affect and Adiposity in Infancy Varies in Social vs. Non-Social Situations. Nutrients 2022; 14:nu14122391. [PMID: 35745120 PMCID: PMC9227739 DOI: 10.3390/nu14122391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/10/2022] Open
Abstract
Previous studies have suggested that infants high in negative affect have higher levels of adiposity, arising in part via changes in nutrition (e.g., “feeding to soothe”). Few studies have examined whether positive affect shows similar or inverse associations with adiposity. The current study examined cross-sectional and longitudinal relationships between adiposity and observations of positive affect in both a social and a non-social context, using data from infants at four (n = 125) and 12 (n = 80) months of age. Our analyses did not find any cross-sectional associations between positive affect and adiposity (all p > 0.05). However, in the longitudinal analyses, positive affect in a non-social context, when observed at four months of age, was positively associated with weight-for-length at 12 months of age (zWFL; ß = 1.49, SE = 0.67, p = 0.03), while positive affect observed at four months of age in a social context was inversely associated with body fat percentage at 12 months of age (ß = −11.41, SE = 5.44, p = 0.04). These findings provide preliminary evidence that the p positive affect is related to adiposity in infancy and suggest that the direction of association (i.e., direct or inverse) may be specific to the context in which positive affect is measured. Future research should examine the role of nutritional status in any relationships between adiposity and emotion at this early stage.
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Affiliation(s)
- Alexis C. Wood
- USDA/ARS Children’s Nutrition Research Center, 1100 Bates Avenue, Houston, TX 77030, USA; (S.R.M.); (M.K.S.)
- Correspondence: ; Tel.: +713-798-7055
| | - Shabnam R. Momin
- USDA/ARS Children’s Nutrition Research Center, 1100 Bates Avenue, Houston, TX 77030, USA; (S.R.M.); (M.K.S.)
| | - MacKenzie K. Senn
- USDA/ARS Children’s Nutrition Research Center, 1100 Bates Avenue, Houston, TX 77030, USA; (S.R.M.); (M.K.S.)
| | - David J. Bridgett
- Department of Psychology, Northern Illinois University, DeKalb, IL 60115, USA;
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Ziegelasch N, Vogel M, Körner A, Koch E, Jurkutat A, Ceglarek U, Dittrich K, Kiess W. Cystatin C relates to metabolism in healthy, pubertal adolescents. Pediatr Nephrol 2022; 37:423-432. [PMID: 34432142 PMCID: PMC8816513 DOI: 10.1007/s00467-021-05209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/05/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The cystatin C (CysC) serum level is a marker of glomerular filtration rate and depends on age, gender, and pubertal stage. We hypothesize that CysC might overall reflect energy homeostasis and be regulated by components of the endocrine system and metabolites in pubertal adolescents. METHODS Serum CysC levels and further possible effector parameters in 5355 fasting, morning venous blood samples from 2035 healthy participants of the LIFE Child cohort study (age 8 to 18 years) were analyzed. Recruitment started in 2011, with probands followed up once a year. Linear univariate and stepwise multivariate regression analyses were performed. RESULTS Annual growth rate, serum levels of thyroid hormones, parathyroid hormone, insulin-like growth factor 1, hemoglobin A1c (HbA1c), uric acid, and alkaline phosphatase show relevant and significant associations with CysC serum concentrations (p <0.001). Furthermore, male probands' CysC correlated with the body mass index and testosterone among other sexual hormones. Multivariate analyses revealed that uric acid and HbA1c are associated variables of CysC independent from gender (p <0.001). In males, alkaline phosphatase (p <0.001) is additionally significantly associated with CysC. Thyroid hormones show significant correlations only in multivariate analyses in females (p <0.001). CONCLUSIONS The described associations strongly suggest an impact of children's metabolism on CysC serum levels. These alterations need to be considered in kidney diagnostics using CysC in adolescents. Additionally, further studies are needed on CysC in children.
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Affiliation(s)
- Niels Ziegelasch
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103, Leipzig, Germany.
| | - Mandy Vogel
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Antje Körner
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Eva Koch
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Anne Jurkutat
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic (ILM), University Hospital Leipzig, 04103 Leipzig, Germany
| | - Katalin Dittrich
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany ,Present Address: DSO, Walter-Koehn-Str. 1a, Organisationszentrale, D-04356 Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
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Favieri F, Forte G, Casagrande M. The Executive Functions in Overweight and Obesity: A Systematic Review of Neuropsychological Cross-Sectional and Longitudinal Studies. Front Psychol 2019; 10:2126. [PMID: 31616340 PMCID: PMC6764464 DOI: 10.3389/fpsyg.2019.02126] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/02/2019] [Indexed: 12/21/2022] Open
Abstract
Background: The increasing incidence of people affected by overweight or obesity is a significant health problem. The knowledge of the factors which influences the inappropriate eating behaviors causing excessive body fat is an essential goal for the research. Overweight and obesity are significant risk factors for many health diseases, such as cardiovascular problems, diabetes. Recently, many studies have focused on the relationship between body weight and cognitive processes. Objectives: This systematic review is aimed to investigate the existence and the nature of the relationship between excessive body weight (overweight/obesity) and executive functions, analyzing cross-sectional, and longitudinal studies in order to verify the evidence of a possible causality between these variables. Methods: The review was carried out according to the PRISMA-Statement, through systematic searches in the scientific databases PubMed, Medline, PsychInfo, and PsycArticles. The studies selected examined performance on executive tasks by participants with overweight or obesity, aged between 5 and 70 years. Studies examining eating disorders or obesity resulting from other medical problems were excluded. Furthermore, the results of studies using a cross-sectional design and those using a longitudinal one were separately investigated. Results: Sixty-three cross-sectional studies and twenty-eight longitudinal studies that met our inclusion and exclusion criteria were analyzed. The results confirmed the presence of a relation between executive functions and overweight/obesity, although the directionality of this relation was not clear; nor did any single executive function emerge as being more involved than others in this relation. Despite this, there was evidence of a reciprocal influence between executive functions and overweight/obesity. Conclusions: This systematic review underlines the presence of a relationship between executive functions and overweight/obesity. Moreover, it seems to suggest a bidirectional trend in this relationship that could be the cause of the failure of interventions for weight reduction. The results of this review highlight the importance of a theoretical model able to consider all the main variables of interest, with the aim to structuring integrated approaches to solve the overweight/obesity problems.
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Affiliation(s)
- Francesca Favieri
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Giuseppe Forte
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
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Abstract
Increased body mass is directly associated with reduced cognitive function. The aim of this study was to systematically review the effect of bariatric weight loss surgery on cognitive function. A comprehensive and unrestricted literature search was conducted using the following databases: MEDLINE, EMBASE, PubMed, Scopus, Web of Sciences, and the Cochrane Library. A total of 414 publications were identified, of which 18 were included in the final review. Cognitive function as measured by a number of different assessment tools was shown to improve following surgically induced weight loss in most studies. Significant and rapid weight loss resulting from bariatric surgery is associated with prompt and sustained improvements in cognitive function including memory, executive function, and cognitive control.
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Higher Cystatin C Levels Are Associated With Neurocognitive Impairment in Older HIV+ Adults. J Acquir Immune Defic Syndr 2017; 74:243-249. [PMID: 27861242 DOI: 10.1097/qai.0000000000001235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The study aims to determine whether cystatin C is associated with HIV disease and HIV-associated neurocognitive impairment (NCI). METHODS Participants included 124 (HIV+ n = 77; HIV- n = 47) older adults (age ≥ 50 years) examined at the University of California, San Diego HIV Neurobehavioral Research Program. Cystatin C, a biomarker of kidney functioning that has been linked to poor health outcomes, was measured in blood. Participants completed a comprehensive neurocognitive assessment that was used to define both global and domain NCI. RESULTS The HIV+ group had significantly higher cystatin C concentrations than the HIV- group (d = 0.79 P < 0.001). Among HIV+ participants, those with NCI had higher cystatin C concentrations than those without NCI (d = 0.42, P = 0.055), particularly among participants taking tenofovir (d = 0.78, P = 0.004). A receiver-operator characteristic curve identified that cystatin C levels ≥0.75 mg/L were associated with NCI in the HIV+ group. Using this binary variable and including relevant covariates, multivariate modeling confirmed that NCI was associated with higher cystatin C levels (OR = 3.0; P = 0.03). CONCLUSIONS Our results confirm that HIV+ older adults have higher cystatin C than HIV- older adults and further identify that cystatin C may be associated with NCI in this population, particularly if they use tenofovir. This blood biomarker may be a useful clinical tool to identify older HIV+ persons at greater risk for cognitive decline.
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Thiara G, Cigliobianco M, Muravsky A, Paoli RA, Mansur R, Hawa R, McIntyre RS, Sockalingam S. Evidence for Neurocognitive Improvement After Bariatric Surgery: A Systematic Review. PSYCHOSOMATICS 2017; 58:217-227. [DOI: 10.1016/j.psym.2017.02.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Spitznagel MB, Gunstad J, Manderino L, Heinberg L. Liver Fibrosis Predicts Cognitive Function Following Bariatric Surgery: A Preliminary Investigation. Obesity (Silver Spring) 2015; 23:1957-9. [PMID: 26414561 DOI: 10.1002/oby.21219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 06/10/2015] [Accepted: 06/15/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Obesity is a well-established risk factor for poor neurological outcomes, and bariatric surgery has been shown to improve many aspects of cognitive function. Factors underlying improved cognition following surgery are not yet fully established. A recent study of bariatric surgery patients demonstrated lower preoperative alkaline phosphatase concentrations were linked to greater postoperative cognitive improvement, but this link has not been examined via liver biopsy. The current study examined postoperative cognitive function in individuals with and without fibrosis at the time of bariatric surgery. It expected that those with fibrosis would demonstrate poorer postoperative cognition. METHODS Thirty-six bariatric surgery patients underwent routine liver biopsy at the time of surgery and completed cognitive testing 1 month postoperatively. RESULTS Bariatric surgery patients with fibrosis demonstrated poorer performance on a task of executive function (maze errors, P = 0.01) and verbal memory (recognition memory, P = 0.01). CONCLUSIONS Bariatric surgery patients with fibrosis demonstrated poorer cognition following surgery, providing further evidence for the connection between liver disease and cognitive function. Future work examining mechanisms underlying bariatric postoperative cognitive changes should include examination of broader metabolic functions, particularly liver function.
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Affiliation(s)
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Lisa Manderino
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Leslie Heinberg
- Behavioral Services, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
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Spitznagel MB, Hawkins M, Alosco M, Galioto R, Garcia S, Miller L, Gunstad J. Neurocognitive Effects of Obesity and Bariatric Surgery. EUROPEAN EATING DISORDERS REVIEW 2015; 23:488-95. [DOI: 10.1002/erv.2393] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/30/2015] [Indexed: 01/02/2023]
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