Spitznagel Mary Beth, Gunstad John, Manderino Lisa, Heinberg Leslie
Department of Psychological Sciences, Kent State University, Kent, Ohio, USA.
Behavioral Services, Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Obesity (Silver Spring). 2015 Oct;23(10):1957-9. doi: 10.1002/oby.21219.
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.
Thirty-six bariatric surgery patients underwent routine liver biopsy at the time of surgery and completed cognitive testing 1 month postoperatively.
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).
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.
肥胖是公认的导致不良神经学预后的风险因素，而减肥手术已被证明可改善认知功能的多个方面。手术后认知改善的潜在因素尚未完全明确。最近一项针对减肥手术患者的研究表明，术前碱性磷酸酶浓度较低与术后认知功能改善程度较大有关，但这一关联尚未通过肝活检进行研究。本研究调查了减肥手术时伴有和不伴有肝纤维化的个体的术后认知功能。预计伴有肝纤维化的个体术后认知功能会较差。
36例减肥手术患者在手术时接受了常规肝活检，并在术后1个月完成了认知测试。
伴有肝纤维化的减肥手术患者在执行功能任务（迷宫错误，P = 0.01）和言语记忆（识别记忆，P = 0.01）方面表现较差。
伴有肝纤维化的减肥手术患者术后认知功能较差，这为肝脏疾病与认知功能之间的联系提供了进一步证据。未来研究减肥手术后认知变化潜在机制的工作应包括对更广泛代谢功能，特别是肝功能的检查。
