Chair and Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Department of Endocrinology and Diabetology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland.
Front Biosci (Landmark Ed). 2022 Mar 1;27(3):76. doi: 10.31083/j.fbl2703076.
The role of executive functions (EF) is to maintain particular behaviours in order to achieve intended goals. EF are crucial in management of pre-diabetes, diabetes and obesity which are grievous diseases and can lead to severe complications. The aims of our study were to: assess EF in group of obese subject with carbohydrate disorders, evaluate whether biochemical factors and comorbidities related to metabolic disorders have adverse effect on EF in this group of patients.
The study included 185 obese patients (146 women; 39 men) who were divided on three groups: pre-diabetic, diabetic and control subgroup. Patient underwent Wisconsin Card Sorting Test (WCST) to evaluate EF. Assessed biochemical factors included C-peptide, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c).
Diabetic patients showed the worst WCST scores among the rest of groups. Pre-diabetic individuals did not differ in EF performance from control subgroup. We observed significant correlations between FPG and HbA1c and worse WCST scores in pre-diabetic subgroup. In diabetic patients C-peptide correlated with poorer EF. Depressive symptoms and hypertension significantly correlated with non-perseverative errors in WCST.
The subgroup of diabetic patients were the most obese and had the worst glycemia parameters. They also showed the worst EF in WCST. According to obtained results, hyperglycemia positively correlated with poor EF in pre-diabetes. However, in diabetic subjects cognitive deterioration may results from insulin resistance rather than hyperglycemia. In obese individuals with carbohydrate disorders both hypertension and depressive symptoms significantly contributed to EF dysfunction.
执行功能（EF）的作用是维持特定的行为，以实现预期的目标。EF 在糖尿病前期、糖尿病和肥胖症的管理中至关重要，这些疾病是严重的疾病，可导致严重的并发症。我们研究的目的是：评估碳水化合物紊乱肥胖患者的 EF，评估与代谢紊乱相关的生化因素和合并症是否对该组患者的 EF 产生不利影响。
本研究纳入了 185 名肥胖患者（146 名女性；39 名男性），分为三组：糖尿病前期、糖尿病和对照组。患者接受威斯康星卡片分类测试（WCST）评估 EF。评估的生化因素包括 C 肽、空腹血糖（FPG）和糖化血红蛋白 A1c（HbA1c）。
糖尿病组患者在其余组中的 WCST 评分最差。糖尿病前期患者的 EF 表现与对照组无差异。我们观察到 FPG 和 HbA1c 与糖尿病前期亚组中较差的 WCST 评分之间存在显著相关性。在糖尿病患者中，C 肽与较差的 EF 相关。抑郁症状和高血压与 WCST 中的非持续错误显著相关。
糖尿病组患者是最肥胖的，血糖参数最差。他们在 WCST 中也表现出最差的 EF。根据获得的结果，糖尿病前期的高血糖与较差的 EF 呈正相关。然而，在糖尿病患者中，认知能力下降可能是由于胰岛素抵抗而不是高血糖引起的。在有碳水化合物紊乱的肥胖个体中，高血压和抑郁症状都显著导致 EF 功能障碍。
