Prunell-Castañé Anna, Jurado María Ángeles, Caldú Xavier, Sender-Palacios María José, Sánchez Garre Consuelo, Salas Gómez-Pablos Paloma, Garolera Maite
Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig de la Vall D'Hebron, Barcelona, Spain.
Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.
Stress Health. 2025 Aug;41(4):e70077. doi: 10.1002/smi.70077.
Overweight and obesity are associated with poorer executive functions (EF). The underlying mechanisms contributing to this relationship are not yet conclusive, but cortisol, anxiety, and inflammation are likely among the contributing factors. Our objective was to evaluate whether fibrinogen, tumour necrosis factor alpha (TNFα), cortisol, and anxiety significantly mediate the association between body mass index (BMI) z-score and EF (i.e., working memory, inhibition, cognitive flexibility, and a latent EF component) in both adolescents and adults. In this cross-sectional study, 268 participants aged 11-49 years with BMI values ranging from normal-weight to obesity were medically and neuropsychologically evaluated. Moderated multiple mediation analyses with mediators in parallel were conducted (X: BMI z-score; M: cortisol, anxiety, TNFα, and fibrinogen; Y: executive functions; Moderator: adolescent and adult groups). Our results suggested that TNFα mediated the association between BMI z-score and working memory only in adolescents (indirect effect = 0.09, 95% CI [0.03, 0.19]), whereas in adults, cortisol (indirect effect = -0.06, 95% CI [-0.13, -0.01]) and anxiety (indirect effect = 0.02, 95% CI [0.0001, 0.07]) mediated this association. Additionally, in adults, anxiety also mediated the relationship between BMI z-score and the latent EF component (indirect effect = 0.03, 95% CI [0.004, 0.08]). In the full sample, TNFα significantly mediated the relationship between BMI z-score and inhibition (indirect effect = -0.03, 95% CI [-0.06, -0.002]). In conclusion, our study suggests that inflammation, cortisol, and anxiety are biologically and psychologically plausible mechanisms through which BMI may influence cognitive performance. Large-scale longitudinal studies are needed to confirm these findings and to determine whether the observed associations are age-dependent.
超重和肥胖与较差的执行功能（EF）相关。导致这种关系的潜在机制尚无定论，但皮质醇、焦虑和炎症可能是其中的促成因素。我们的目的是评估纤维蛋白原、肿瘤坏死因子α（TNFα）、皮质醇和焦虑是否显著介导了青少年和成年人中体重指数（BMI）z评分与执行功能（即工作记忆、抑制、认知灵活性和潜在的执行功能成分）之间的关联。在这项横断面研究中，对268名年龄在11至49岁、BMI值从正常体重到肥胖的参与者进行了医学和神经心理学评估。进行了带有平行中介变量的调节多重中介分析（X：BMI z评分；M：皮质醇、焦虑、TNFα和纤维蛋白原；Y：执行功能；调节变量：青少年和成年组）。我们的结果表明，TNFα仅在青少年中介导了BMI z评分与工作记忆之间的关联（间接效应 = 0.09，95%置信区间[0.03，0.19]），而在成年人中，皮质醇（间接效应 = -0.06，95%置信区间[-0.13，-0.01]）和焦虑（间接效应 = 0.02，95%置信区间[0.0001，0.07]）介导了这种关联。此外，在成年人中，焦虑还介导了BMI z评分与潜在执行功能成分之间的关系（间接效应 = 0.03，95%置信区间[0.004，0.08]）。在整个样本中，TNFα显著介导了BMI z评分与抑制之间的关系（间接效应 = -0.
