Zouridis Spyridon, Nasir Ahmad Basil, Aspichueta Patricia, Syn Wing-Kin
Division of Gastroenterology and Hepatology, Saint Louis University, St. Louis, Missouri, USA,
Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU, Leioa, Spain,
Digestion. 2025;106(3):203-211. doi: 10.1159/000541696. Epub 2024 Oct 5.
Metabolic syndrome (MetS) is a cluster of cardiometabolic conditions that has been linked to high risk for cardiovascular disease, liver complications, and several malignancies. More recently, MetS has been associated with cognitive dysfunction.
Studies have shown an association with minimal cognitive impairment, progression to vascular dementia, and even Alzheimer's disease. MetS components have been individually explored, and glucose intolerance has the strongest association with impairment in several cognitive domains. Several hypotheses have been proposed regarding the pathophysiology underlying the MetS-cognitive dysfunction association, and even though insulin resistance plays a major role, more studies are needed to elucidate this topic. Moreover, several other factors contributing to this association have been identified. Liver disease and more specifically metabolic dysfunction-associated steatotic liver disease can on its own contribute to cognitive decline through systemic inflammation and higher ammonia levels. Gut dysbiosis that has also been identified in MetS can also lead to cognitive impairment through several mechanisms that result in neurotoxicity. Finally, there are several other factors that may modify the MetS-cognitive dysfunction relationship, such as lifestyle, diet, education status, and age. More recently, circadian syndrome was explored and was found to be even more strongly associated with cognitive impairment.
MetS is associated with cognitive decline. Certain cardiometabolic risk factors have a stronger association with cognitive impairment, and there are several factors that may modify this relationship. The aim of this review was to assess and summarize the existing body of evidence on the association between MetS and cognitive impairment and identify areas that necessitate further investigation.
代谢综合征（MetS）是一组心脏代谢疾病，与心血管疾病、肝脏并发症及多种恶性肿瘤的高风险相关。最近，代谢综合征还与认知功能障碍有关。
研究表明，代谢综合征与轻度认知障碍、进展为血管性痴呆甚至阿尔茨海默病有关。已对代谢综合征的各个组成部分进行了单独研究，其中葡萄糖耐量异常与多个认知领域的损害关联最为密切。针对代谢综合征与认知功能障碍关联背后的病理生理学提出了几种假说，尽管胰岛素抵抗起主要作用，但仍需要更多研究来阐明这一主题。此外，还确定了导致这种关联的其他几个因素。肝脏疾病，尤其是代谢功能障碍相关脂肪性肝病，可通过全身炎症和较高的血氨水平单独导致认知功能下降。在代谢综合征中也已发现的肠道菌群失调，也可通过多种导致神经毒性的机制导致认知障碍。最后，还有其他几个因素可能会改变代谢综合征与认知功能障碍的关系，如生活方式、饮食、教育程度和年龄。最近对昼夜节律综合征进行了研究，发现其与认知障碍的关联更强。
代谢综合征与认知功能下降有关。某些心脏代谢危险因素与认知障碍的关联更强，并且有几个因素可能会改变这种关系。本综述的目的是评估和总结关于代谢综合征与认知障碍关联的现有证据，并确定需要进一步研究的领域。
