Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Division of Endocrinology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
Obes Surg. 2021 Jul;31(7):3372-3378. doi: 10.1007/s11695-021-05386-x. Epub 2021 Apr 7.
There is a global increase in the prevalence of severe obesity in females during adolescence, which is a critical period for neurocognitive development. An increasing number of adolescents and young adults are now undergoing weight loss surgery as a treatment strategy for obesity. In addition to metabolic complications, obesity has been linked to neurocognitive comorbidity, and studies exploring cognitive performance in adolescents with severe obesity and the impact of bariatric surgery on cognitive abilities are limited. Verbal memory and executive function were assessed cross-sectionally in 69 females with moderate to severe obesity and 24 females without obesity, 13-24 years old. In an exploratory analysis, cognitive changes were also assessed longitudinally over 12 months in a subset of 35 females with moderate to severe obesity following weight loss surgery (n = 21) or following usual care without surgery (n = 14). In cross-sectional analysis, females with moderate to severe obesity showed lower scores for short-term and long-term recall (verbal memory) and response inhibition and cognitive flexibility (executive function) than the comparison group, when adjusted for age and baseline intelligence. Females with moderate to severe obesity who underwent surgery showed significant weight loss but no improvement in verbal memory and executive function scores over 12 months compared with those who did not have surgery. Females with moderate to severe obesity demonstrate worse performance in tests of verbal memory and executive function than the comparison group without obesity. In addition, exploratory analyses provide no indication that weight loss surgery improves these observed cognitive decrements over a period of 12 months. Further studies are necessary to comprehensively evaluate changes in cognitive function following bariatric surgery.
在青春期，女性重度肥胖的患病率在全球范围内呈上升趋势，而青春期是神经认知发展的关键时期。越来越多的青少年和年轻人现在选择接受减肥手术作为肥胖的治疗策略。除了代谢并发症外，肥胖还与神经认知共病有关，目前探索严重肥胖青少年认知表现以及减重手术对认知能力影响的研究有限。本研究对 69 名中重度肥胖女性和 24 名非肥胖女性（年龄 13-24 岁）进行了横断面研究，评估了她们的言语记忆和执行功能。在一项探索性分析中，还对 35 名中重度肥胖女性中的一小部分（n=21 名接受减重手术，n=14 名未接受手术）进行了纵向研究，评估了 12 个月内的认知变化。在横断面分析中，与对照组相比，中重度肥胖女性的短期和长期回忆（言语记忆）、反应抑制和认知灵活性（执行功能）得分较低，校正年龄和基线智力后差异仍有统计学意义。接受手术的中重度肥胖女性在 12 个月时体重显著减轻，但言语记忆和执行功能评分与未接受手术的女性相比无改善。与非肥胖对照组相比，中重度肥胖女性在言语记忆和执行功能测试中的表现更差。此外，探索性分析表明，减重手术在 12 个月的时间内不能改善这些观察到的认知缺陷。需要进一步的研究来全面评估减肥手术后认知功能的变化。
