减肥手术后 12 周记忆力改善。
Improved memory function 12 weeks after bariatric surgery.
机构信息
Department of Psychology, Kent State University, Kent, Ohio, USA.
出版信息
Surg Obes Relat Dis. 2011 Jul-Aug;7(4):465-72. doi: 10.1016/j.soard.2010.09.015. Epub 2010 Oct 30.
BACKGROUND
Growing evidence has shown that obesity is associated with poor neurocognitive outcomes. Bariatric surgery has been shown to be an effective intervention for morbid obesity and can result in improvement of many co-morbid medical conditions that are associated with cognitive dysfunction. The effects of bariatric surgery on cognition are unknown.
METHODS
We performed a prospective study total of 150 subjects (109 bariatric surgery patients enrolled in the Longitudinal Assessment of Bariatric Surgery project and 41 obese control subjects who had not undergone bariatric surgery). These 150 subjects completed a cognitive evaluation at baseline and at 12 weeks of follow-up. The demographic, medical, and psychosocial information was also collected to elucidate the possible mechanisms of change.
RESULTS
Many bariatric surgery patients exhibited impaired performance on cognitive testing at baseline (range 4.6-23.9%). However, the surgery patients were no more likely to exhibit a decline on ≥2 cognitive tests at 12 weeks of follow-up than were the obese controls [12.84% versus 23.26%; chi-square (1) = 2.51, P = .11]. Group comparisons using repeated measures multivariate analysis of variance showed that the surgery patients had improved memory performance at 12 weeks of follow-up [λ = .86, F(4, 147) = 5.88, P <.001]; however, the memory performance of the obese controls had actually declined. Regression analyses showed that the surgery patients without hypertension had better short delay recall at 12 weeks than those with hypertension [β = .31, P = .005], although the other demographic and medical variables were largely unrelated to the test performance.
CONCLUSION
The present results suggest that cognitive impairment is common in bariatric surgery patients, although these deficits might be at least partly reversible. Future studies are needed to clarify the underlying mechanisms, in particular, longitudinal studies using neuroimaging and blood markers.
背景
越来越多的证据表明，肥胖与神经认知结果不佳有关。减重手术已被证明是治疗病态肥胖的有效干预措施，可改善与认知功能障碍相关的许多合并症。减重手术对认知的影响尚不清楚。
方法
我们进行了一项前瞻性研究，共纳入 150 名受试者（109 名接受减重手术的患者，纳入纵向评估减重手术项目，41 名未接受减重手术的肥胖对照受试者）。这 150 名受试者在基线和随访 12 周时完成认知评估。还收集了人口统计学、医学和社会心理信息，以阐明可能的变化机制。
结果
许多减重手术患者在基线时认知测试表现受损（范围为 4.6-23.9%）。然而，与肥胖对照组相比，手术患者在 12 周随访时出现≥2 项认知测试下降的可能性并不更高[12.84%比 23.26%；卡方（1）= 2.51，P =.11]。使用重复测量多元方差分析的组间比较显示，手术患者在 12 周随访时记忆表现有所改善[λ=.86，F(4, 147)=5.88，P<.001]；然而，肥胖对照组的记忆表现实际上有所下降。回归分析显示，无高血压的手术患者在 12 周时的短延迟回忆优于高血压患者[β=.31，P =.005]，尽管其他人口统计学和医学变量与测试表现基本无关。
结论
目前的结果表明，认知障碍在减重手术患者中很常见，尽管这些缺陷至少在一定程度上是可逆的。需要进一步的研究来阐明潜在的机制，特别是使用神经影像学和血液标志物的纵向研究。
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