The Association Between Reduced Inflammation and Cognitive Gains After Bariatric Surgery.
The Association Between Reduced Inflammation and Cognitive Gains After Bariatric Surgery.
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DOI：
10.1097/psy.0000000000000125
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发表时间：
2015-07
影响因子：
3.3
通讯作者：
Gunstad J
中科院分区：
文献类型：
--
作者：
Hawkins MA;Alosco ML;Spitznagel MB;Strain G;Devlin M;Cohen R;Crosby RD;Mitchell JE;Gunstad J
减肥手术与认知功能的改善有关，尽管其机制尚不清楚。炎症升高在肥胖症中很常见，并与认知受损有关。减肥手术后炎症减少，暗示它是认知改善的可能机制。本研究的目的是检查减轻炎症是否是减肥手术患者术后认知改善的可能机制。参与者是77名减肥手术患者，他们在手术前和手术后一年完成了认知测试。评估的认知领域包括注意力/执行功能、语言和记忆。在两个时间点评估高敏C反应蛋白（hs-CRP）。患者表现出术前认知功能障碍，但注意力/执行力（M± SD基线= 53.57 ± 8.68 vs.M± SD随访= 60.32 ± 8.19）和记忆力（M± SD基线= 44.96 ± 7.98 vs.M± SD随访= 51.55 ± 8.25）在术后1年有所改善。CRP在基线时升高，术后降至正常范围（M± SD基线= 0.9 ± 0.7 vs. M ± SD随访= 0.2 ± 0.3 mg/dL）。术前CRP与基线认知功能无关（β值= -0.10至0.02），CRP的变化也与术后认知的变化无关（β值= 0.02至β = 0.11;所有领域的ps>0.05）。在基线CRP升高（>0.30 mg/dL）的参与者中，与正常水平的参与者相比，检测到记忆力改善较小的趋势（组x时间：p=0.083）。hs-CRP的改善与术后认知功能的改善无关。未来的研究需要探索其他炎症标志物和减肥手术后认知改善的潜在机制，包括改善血糖控制和神经激素变化。
Bariatric surgery is associated with improved cognitive function, though the mechanisms are unclear. Elevated inflammation is common in obesity and associated with impaired cognition. Inflammation decreases after bariatric surgery, implicating it as a possible mechanism for cognitive improvement. The objective of this study was to examine whether reduced inflammation is a possible mechanism for post-operative cognitive improvement in bariatric surgery patients. Participants were 77 bariatric surgery patients who completed cognitive testing before surgery and one year post-surgery. Cognitive domains assessed were attention/executive function, language, and memory. High-sensitivity C-reactive protein (hs-CRP) was assessed at both time points. Patients exhibited pre-operative cognitive impairment, though attention/executive (M±SDbaseline= 53.57 ± 8.68 vs.M±SDfollow-up= 60.32 ± 8.19) and memory (M±SDbaseline= 44.96 ± 7.98 vs.M±SDfollow-up= 51.55 ± 8.25) improved one year post-surgery. CRP was elevated at baseline and fell into the normative range post-surgery (M±SDbaseline= 0.9 ± 0.7vs.M±SDfollow-up= 0.2 ± 0.3 mg/dL). Pre-operative CRP was not associated with baseline cognitive function (β-values = -0.10 to 0.02) and changes in CRP also did not correspond to changes in cognition post-surgery (β-values = 0.02 to β = 0.11; ps>0.05 for all domains). A trend was detected for smaller improvements in memory among participants with elevated baseline CRP (>0.30 mg/dL) versus those with normal levels (Group x Time: p=0.083). Improvements in hs-CRP were not associated with post-operative cognitive benefits. Future studies are needed to explore other inflammatory markers and potential mechanisms of cognitive improvement after bariatric surgery, including improved glycemic control and neurohormone changes.