Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
CNS Spectr. 2021 Oct;26(5):521-527. doi: 10.1017/S1092852920001534. Epub 2020 Jun 29.
Studies have suggested the detrimental effects of obesity and systemic inflammation on the cognitive function of patients with bipolar or major depressive disorder. However, the complex associations between affective disorder, obesity, systemic inflammation, and cognitive dysfunction remain unclear.
Overall, 110 patients with affective disorder (59 with bipolar I disorder and 51 with major depressive disorder) who scored ≥61 on the Global Assessment of Functioning and 51 age- and sex-matched controls were enrolled. Body mass index ≥25 kg/m2 was defined as obesity or overweight. Levels of proinflammatory cytokines-including interleukin-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP)-were measured, and cognitive function was assessed using various methods, including the Wisconsin Card Sorting Test (WCST) and go/no-go task.
Patients with bipolar I disorder or major depressive disorder were more likely to be obese or overweight, had higher CRP and TNF-α levels, and had greater executive dysfunction in the WCST than the controls. TNF-α level (P < .05) but not affective disorder diagnosis or obesity/overweight was significantly associated with cognitive function deficits, although obesity/overweight and diagnosis were significantly associated with increased TNF-α level.
Our findings may indicate that proinflammatory cytokines, but not obesity or overweight, have crucial effects on cognitive function in patients with bipolar I disorder or major depressive disorder, although proinflammatory cytokines and obesity or overweight were found to be strongly associated. The complex relationships between affective disorder diagnosis, proinflammatory cytokine levels, obesity or overweight, and cognitive function require further investigation.
研究表明肥胖和全身炎症对双相或重性抑郁障碍患者的认知功能有不良影响。然而，情感障碍、肥胖、全身炎症和认知功能障碍之间的复杂关联仍不清楚。
共有 110 名符合以下标准的情感障碍患者（59 名双相 I 型障碍患者和 51 名重性抑郁障碍患者）和 51 名年龄和性别匹配的对照者纳入研究，这些患者的总体功能评估得分为≥61 分，且体质量指数（BMI）≥25kg/m2 定义为肥胖或超重。检测促炎细胞因子水平，包括白细胞介素 6（IL-6）、肿瘤坏死因子-α（TNF-α）和 C 反应蛋白（CRP），并使用威斯康星卡片分类测验（WCST）和 Go/No-go 任务等多种方法评估认知功能。
与对照组相比，双相 I 型障碍或重性抑郁障碍患者更可能肥胖或超重，CRP 和 TNF-α 水平更高，WCST 执行功能障碍更明显。TNF-α 水平（P＜.05）而非情感障碍诊断或肥胖/超重与认知功能缺陷显著相关，尽管肥胖/超重和诊断与 TNF-α 水平升高显著相关。
我们的发现可能表明，促炎细胞因子而非肥胖或超重对双相 I 型障碍或重性抑郁障碍患者的认知功能有重要影响，尽管促炎细胞因子和肥胖或超重之间存在强烈关联。情感障碍诊断、促炎细胞因子水平、肥胖或超重与认知功能之间的复杂关系需要进一步研究。
