Pino Jessica M V, Silva Vitória F, Mônico-Neto Marcos, Seva Danielle C, Kato Melissa Y, Alves July N, Pereira Gabriela C, Antunes Hanna Karen M, Galvao Thales D, Bitterncourt Lia R A, Tufik Sergio, Zambrano Lysien I, Dâmaso Ana R, Oyama Lila M, Thivel David, Campos Raquel M S, Lee Kil S
Department of Biochemistry, Universidade Federal de São Paulo, Sao Paulo, Brazil.
Post Graduated Program of Interdisciplinary Health Sciences, Universidade Federal de São Paulo, Santos, Brazil.
Int J Endocrinol. 2023 Apr 17;2023:7625720. doi: 10.1155/2023/7625720. eCollection 2023.
Obesity is one of the modifiable risk factors for dementia. Insulin resistance, the abundance of advanced glycated end-products, and inflammation are some of the mechanisms associated with the lower cognitive performance observed in obesity. This study aims to evaluate the cognitive function of subjects with distinct degrees of obesity, comparing class I and II obesity (OBI/II) to class III obesity (OBIII), and to investigate metabolic markers that can distinguish OBIII from OBI/II. This is a cross-sectional study, in which 45 females with BMI varying from 32.8 to 51.9 kg/m completed a set of 4 cognitive tests (verbal paired-associate test, stroop color, digit span, and Toulouse-Pieron cancellation test) and their plasma metabolites, enzymes, and hormones related to glycemia, dyslipidemia, and liver function, as well as the biomarkers of iron status, were concomitantly analyzed.
OBIII showed lower scores in the verbal paired-associate test compared to OBI/II. In other cognitive tests, both groups showed similar performance. OBIII presented a lower iron status compared to OBI/II based on total iron binding capacity, degree of transferrin saturation, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. The levels of indicators for glycemia, liver function, and lipid metabolism were similar in both groups. Analysis of plasma metabolites showed that OBIII had lower levels of pyroglutamic acid, myoinositol, and aspartic acid and higher levels of D-ribose than OBI/II.
Iron is an essential micronutrient for several metabolic pathways. Thus, iron dyshomeostasis observed in severe obesity may aggravate the cognitive impairment by altering metabolic homeostasis and enhancing oxidative stress. These findings can contribute to searching for biomarkers that indicate cognitive performance in the population with obesity.
肥胖是痴呆可改变的危险因素之一。胰岛素抵抗、晚期糖基化终末产物的大量存在以及炎症是与肥胖中观察到的较低认知表现相关的一些机制。本研究旨在评估不同肥胖程度受试者的认知功能，比较 I 级和 II 级肥胖（OBI/II）与 III 级肥胖（OBIII），并研究可区分 OBIII 与 OBI/II 的代谢标志物。这是一项横断面研究，其中 45 名体重指数（BMI）在 32.8 至 51.9 kg/m 之间的女性完成了一组 4 项认知测试（言语配对联想测试、斯特鲁普颜色测试、数字广度测试和图卢兹 - 皮埃隆消去测试），并同时分析了她们与血糖、血脂异常和肝功能相关的血浆代谢物、酶和激素，以及铁状态的生物标志物。
与 OBI/II 相比，OBIII 在言语配对联想测试中的得分较低。在其他认知测试中，两组表现相似。基于总铁结合能力、转铁蛋白饱和度、血红蛋白、平均红细胞体积和平均红细胞血红蛋白，OBIII 的铁状态低于 OBI/II。两组的血糖、肝功能和脂质代谢指标水平相似。血浆代谢物分析表明，与 OBI/II 相比，OBIII 的焦谷氨酸、肌醇和天冬氨酸水平较低，而 D - 核糖水平较高。
铁是多种代谢途径必需的微量营养素。因此，在严重肥胖中观察到的铁稳态失衡可能通过改变代谢稳态和增强氧化应激来加重认知障碍。这些发现有助于寻找指示肥胖人群认知表现的生物标志物。
