Bahchevanov Karamfil M, Dzhambov Angel M, Chompalov Kostadin A, Massaldjieva Radka I, Atanassova Penka A, Mitkov Mitko D
Department of Neurology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.
Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
Arch Clin Neuropsychol. 2021 May 21;36(4):498-506. doi: 10.1093/arclin/acaa081.
Metabolic syndrome (MetS) has been associated with impaired cognition in different cognitive domains. This study investigated the association between MetS and cognitive functioning in middle-aged Bulgarians across different definitions of MetS severity.
Our cross-sectional sample included 112 participants (67 free of MetS and 45 with MetS) with a mean age of 50.04 ± 3.31 years. The following MetS variables were considered-presence of MetS, continuously measured MetS components, dichotomized MetS components, number of MetS components present, and Metabolic Syndrome Severity Score (MSSS). Participants' cognitive performance was assessed using the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB). We employed multivariate regression models to investigate the associations between different measures of MetS severity and CERAD-NB total and subtest scores.
Bivariate analyses showed that the CERAD-NB total score was significantly higher in women, participants with a university degree, those with normal blood pressure, normal waist circumference, and low triglyceride levels, compared with their counterparts. MetS participants had lower CERAD-NB total score (78.87 ± 6.89 vs. 84.97 ± 7.84) and specifically performed poorer on the subtest Word List Recall (7.16 ± 1.52 vs. 7.99 ± 1.52). These findings persisted after controlling for age, gender, and education. Next, generalized linear regression indicated that the CERAD-NB total score was lower in participants with MetS (β = -4.86; 95% confidence interval [CI]: -7.60, -2.11), those with more MetS components (β = -8.31; 95% CI: -14.13, -2.50 for fours vs. 0 components) and with an increase in MSSS (β = -3.19; 95% CI: -4.67, -1.71). Hypertension independently contributed to lower CERAD-NB total score (β = -4.00; 95% CI: -6.81, -1.19).
Across several definitions, MetS was associated with lower cognitive functioning, and MetS severity appeared to be a better predictor than most MetS components. Recognizing and reducing severity of MetS components might be helpful in supporting cognitive functioning. Further longitudinal research is needed to shed more light on the relationship between MetS and cognitive functioning across the life span.
代谢综合征（MetS）与不同认知领域的认知功能受损有关。本研究调查了保加利亚中年人群中，不同严重程度定义下的MetS与认知功能之间的关联。
我们的横断面样本包括112名参与者（67名无MetS，45名有MetS），平均年龄为50.04±3.31岁。考虑了以下MetS变量：MetS的存在情况、连续测量的MetS组分、二分法的MetS组分、存在的MetS组分数量以及代谢综合征严重程度评分（MSSS）。使用阿尔茨海默病神经心理成套测验注册库联盟（CERAD-NB）评估参与者的认知表现。我们采用多元回归模型来研究不同MetS严重程度测量指标与CERAD-NB总分及子测验分数之间的关联。
双变量分析显示，与相应人群相比，女性、拥有大学学位者、血压正常者、腰围正常者以及甘油三酯水平低者的CERAD-NB总分显著更高。患有MetS的参与者CERAD-NB总分较低（78.87±6.89 vs. 84.97±7.84），并且在子测验单词列表回忆方面表现尤其较差（7.16±1.52 vs. 7.99±1.52）。在控制年龄、性别和教育因素后，这些发现仍然存在。接下来，广义线性回归表明，患有MetS的参与者（β=-4.86；95%置信区间[CI]：-7.60，-2.11）、MetS组分更多的参与者（β=-8.31；95% CI：四分位数相对于零组分时为-14.13，-2.50）以及MSSS增加的参与者（β=-3.19；95% CI：-4.67，-1.71）的CERAD-NB总分较低。高血压独立导致CERAD-NB总分降低（β=-4.00；95% CI：-6.81，-1.19）。
在多种定义下，MetS与较低的认知功能相关，并且MetS严重程度似乎比大多数MetS组分更能作为预测指标。认识并降低MetS组分的严重程度可能有助于维持认知功能。需要进一步的纵向研究来更深入地了解MetS与整个生命周期认知功能之间的关系。
