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Lammers-Lietz F, Borchers F, Feinkohl I, Hetzer S, Kanar C, Konietschke F, Lachmann G, Chien C, Spies C, Winterer G, Zaborszky L, Zacharias N, Paul F. An exploratory research report on brain mineralization in postoperative delirium and cognitive decline. Eur J Neurosci 2024; 59:2646-2664. [PMID: 38379517 PMCID: PMC11108748 DOI: 10.1111/ejn.16282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/20/2024] [Accepted: 01/30/2024] [Indexed: 02/22/2024]
Abstract
Delirium is a severe postoperative complication associated with poor overall and especially neurocognitive prognosis. Altered brain mineralization is found in neurodegenerative disorders but has not been studied in postoperative delirium and postoperative cognitive decline. We hypothesized that mineralization-related hypointensity in susceptibility-weighted magnetic resonance imaging (SWI) is associated with postoperative delirium and cognitive decline. In an exploratory, hypothesis-generating study, we analysed a subsample of cognitively healthy patients ≥65 years who underwent SWI before (N = 65) and 3 months after surgery (N = 33). We measured relative SWI intensities in the basal ganglia, hippocampus and posterior basal forebrain cholinergic system (pBFCS). A post hoc analysis of two pBFCS subregions (Ch4, Ch4p) was conducted. Patients were screened for delirium until the seventh postoperative day. Cognitive testing was performed before and 3 months after surgery. Fourteen patients developed delirium. After adjustment for age, sex, preoperative cognition and region volume, only pBFCS hypointensity was associated with delirium (regression coefficient [90% CI]: B = -15.3 [-31.6; -0.8]). After adjustments for surgery duration, age, sex and region volume, perioperative change in relative SWI intensities of the pBFCS was associated with cognitive decline 3 months after surgery at a trend level (B = 6.8 [-0.9; 14.1]), which was probably driven by a stronger association in subregion Ch4p (B = 9.3 [2.3; 16.2]). Brain mineralization, particularly in the cerebral cholinergic system, could be a pathomechanism in postoperative delirium and cognitive decline. Evidence from our studies is limited because of the small sample and a SWI dataset unfit for iron quantification, and the analyses presented here should be considered exploratory.
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Affiliation(s)
- Florian Lammers-Lietz
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- PI Health Solutions GmbH, Berlin, Germany
| | - Friedrich Borchers
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Insa Feinkohl
- Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Faculty of Health at Department of Medicine, Witten/Herdecke University, Witten, Germany
| | - Stefan Hetzer
- Berlin Center for Advanced Neuroimaging, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Cicek Kanar
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Frank Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Gunnar Lachmann
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- BIH Academy, Clinician Scientist Program, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Chien
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Georg Winterer
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- PI Health Solutions GmbH, Berlin, Germany
- Pharmaimage Biomarker Solutions Inc., Cambridge, Massachusetts, USA
| | - Laszlo Zaborszky
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, New Jersey, USA
| | - Norman Zacharias
- Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Pharmaimage Biomarker Solutions Inc., Cambridge, Massachusetts, USA
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
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Jowshan MR, Rafraf M, Hashemi AH, Hajjarzadeh S, Asghari-Jafarabadi M, Asghari S. Association between healthy eating index-2015 scores and metabolic syndrome among Iranian women: a cross-sectional study. BMC Womens Health 2024; 24:30. [PMID: 38191413 PMCID: PMC10775652 DOI: 10.1186/s12905-023-02876-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is one of the leading public health issues in the world with a reported prevalence of nearly 25% in the past decades in Iran. The present research aimed to identify the association between the Healthy Eating Index (HEI) and MetS components among female teachers. METHODS In this cross-sectional study, 97 female teachers aged 31-57 years were enrolled from 2018 to 2019 in Qom, Iran. Usual dietary intakes were assessed using a validated 168-item Food Frequency Questionnaire (FFQ). HEI-2015 was calculated according to the consumption of whole fruits, vegetables, protein foods, beans, seafood, plant proteins, total and refined grain, dairy, fatty acid ratio, saturated fats, added sugars, and sodium. We also measured anthropometric and biochemical parameters. To evaluate the association between HEI-2015 and MetS, multivariate logistic regression was performed. RESULTS MetS was found in 59.8% of participants. Total HEI-2015 scores were significantly lower in participants with MetS compared to those without MetS (59.69 ± 8.98 vs. 64.21 ± 8.71, respectively; p = 0.02). Daily energy intake, weight, body mass index, waist circumference, systolic and diastolic blood pressure, serum triglyceride, and fasting blood sugar levels were higher in women with MetS (all p < 0.05). Higher HEI-2015 total scores (OR: 0.94; 95% CI: 0.89-0.99; p = 0.02) and scores of total vegetables (OR: 0.62; 95% CI: 0.42-0.91; p = 0.02), dark green vegetables and beans (OR: 0.62; 95% CI: 0.39-0.98; p = 0.04), fatty acid ratio (OR: 0.83; 95% CI: 0.68-0.99; p = 0.04), refined grain (OR: 0.86; 95% CI: 0.75-0.99; p = 0.04), and added sugars (OR: 0.44; 95% CI: 0.26-0.75; p = 0.002) were all associated with lower odds of having MetS. CONCLUSIONS Higher HEI-2015 scores, particularly in total vegetables, dark green vegetables, beans, and fatty acid ratio, as well as refined grain and added sugars were found to be associated with reduced odds of having MetS among Iranian female teachers. However, further prospective studies are required to confirm this finding.
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Affiliation(s)
- Mohammad-Reza Jowshan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 141556117, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir-Hossein Hashemi
- Students' Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Hajjarzadeh
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, 154 Wattletree Rd, Malvern, VIC, 3144, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, 3800, Australia
| | - Somayyeh Asghari
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, No#44, Hojjatdoust St., Naderi St., Keshavarz Blvd, Tehran, 141556117, Iran.
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Wen J, Hao X, Jia Y, Wang B, Pang J, Liang F. Sex Differences in the Association Between LDL/HDL with Cognitive Decline in Older Adults: National Health and Nutrition Examination Survey. J Alzheimers Dis 2024; 98:1493-1502. [PMID: 38578891 DOI: 10.3233/jad-231195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Background Lipids have a significant impact on the development and functioning of the nervous system, but the sex differences between the association of LDL/HDL, which reflects lipid metabolic status, and cognitive impairment remains unclear. Objective We aimed to determine if there were sex differences between the association of LDL/HDL and cognitive function in US older adults. Methods This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles. The main outcome was poor cognitive performance defined by the Digit Symbol Substitution Test (DSST) < 34 based on published literature. Results A total of 1,225 participants were included in the study, with a cognitive impairment incidence of 25.6% (314/1,225). Multivariate regression models demonstrated a significant association between cognitive decline and each 1-unit increase in LDL/HDL, after adjusting for all covariates (adjusted odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.11-1.67). Furthermore, subgroup analysis revealed an interaction between LDL/HDL and cognitive impairment in sex subgroups. Conclusions LDL/HDL was associated with cognitive impairment in the US older adult population in adjusted models, although the significance of this association was not observed in females.
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Affiliation(s)
- Jiaqi Wen
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Xiwa Hao
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Yanhong Jia
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Baojun Wang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Jiangxia Pang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Furu Liang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
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Zhao X, Lu C, Song B, Chen D, Teng D, Shan Z, Teng W. The prevalence and clustering of metabolic syndrome risk components in Chinese population: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1290855. [PMID: 38152127 PMCID: PMC10751355 DOI: 10.3389/fendo.2023.1290855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023] Open
Abstract
Objective The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components. The present study evaluated the epidemiological characteristics of the MetS components and their clustering condition among Chinese adults. Methods 68383 participants aged 18-80 years from TIDE were scored on a six-point (0-5) MetS severity score (MSSS), which quantified their cumulative amount of MetS risk components. We evaluated the epidemiological characteristics of these components and their clustering conditions. Additionally, we examined the relation of age with the prevalence of different MSSSs or specific MetS components using restricted cubic splines. Results Among 68383 participants, 26113 men and 24582 women had abnormal MetS components. There were significant differences in most epidemiological characteristics between the 6 MSSS groups. The top three prevalence of abnormal metabolic components were high systolic blood pressure (SBP) (9.41%, n=6568), high waist circumference (WC) (8.13%, n=6120), and the cooccurrence of high SBP and high WC (6.33%, n=4622). Participants were more likely to have all five MetS components when HDL-C was low. Restricted cubic splines showed that when the MSSS ≥3, the MetS prevalence of male peaked and that of the female population increased most rapidly at 40-60 age group. Conclusion The 40-60 age group can be regarded as the high-risk period of MetS, and elderly women have a higher risk of multiple metabolic disorders than men. The top three clustering of abnormal metabolic components were high SBP, high WC, and their combination. Multiple components aggregation was more likely to occur when HDL-C decreased.
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Affiliation(s)
| | | | | | | | - Di Teng
- The Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Koutsonida M, Koskeridis F, Markozannes G, Kanellopoulou A, Mousas A, Ntotsikas E, Ioannidis P, Aretouli E, Tsilidis KK. Metabolic syndrome and cognitive deficits in the Greek cohort of Epirus Health Study. Neurol Sci 2023; 44:3523-3533. [PMID: 37162663 PMCID: PMC10495510 DOI: 10.1007/s10072-023-06835-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/28/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Metabolic syndrome is considered an important risk factor for cognitive decline and dementia. However, the evidence in middle-aged individuals is still conflicting. The aim of the study was to explore the association between metabolic syndrome and its individual components with cognitive function and to investigate possible interaction between sex, age and genetic predisposition for metabolic syndrome and Alzheimer's disease in a middle-aged Greek cohort. METHODS A total of 2,077 healthy adults (mean age: 46.7 years) were included in the primary cross-sectional analysis and 305 of them in secondary prospective analyses. Metabolic syndrome was defined by the revised National Cholesterol Education-Adult Treatment Panel III and the International Diabetes Federation criteria. Cognitive function was measured primarily with the Trail Making, Verbal fluency and Logical Memory test, and in secondary prospective analyses with online versions of Posner cueing task, an emotional recognition task, Corsi block-tapping task and Stroop task. RESULTS Multivariable linear regressions showed an association of metabolic syndrome with lower performance in attention (β=1.62 seconds, 95% CI=0.20, 3.04) and memory (β=-0.62 words, 95% CI=-1.19, -0.05) that could be driven by associations with elevated fasting glucose and abdominal obesity. Similar associations were observed in the secondary prospective analyses. CONCLUSION In summary, metabolic syndrome was associated with cognitive deficits in domains related with the cognitive profile of vascular cognitive impairment.
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Affiliation(s)
- Myrto Koutsonida
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Fotios Koskeridis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Afroditi Kanellopoulou
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Abdou Mousas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Evangelos Ntotsikas
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Panagiotis Ioannidis
- B' Department of Neurology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Department of Psychology, School of Social Sciences, University of Ioannina, Ioannina, Greece.
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece.
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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Vásquez E, Kuniholm MH, Appleton AA, Rubin LH, Adimora AA, Fischl MA, Fox E, Mack WJ, Holman S, Moran CA, Minkoff H, Plankey MW, Sharma A, Tien PC, Weber KM, Gustafson DR. Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV. Front Endocrinol (Lausanne) 2023; 14:1108313. [PMID: 37484940 PMCID: PMC10361616 DOI: 10.3389/fendo.2023.1108313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Background and objective Observations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP. Methods Four hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women's Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics. Results At baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5-24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p's<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15]. Conclusion Our cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results.
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Affiliation(s)
- Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Mark H. Kuniholm
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Allison A. Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Leah H. Rubin
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
- Department of Psychology, Johns Hopkins University, Baltimore, MD, United States
- Department Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Ada A. Adimora
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Margaret A. Fischl
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ervin Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Wendy J. Mack
- Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Susan Holman
- Department of Medicine/STAR Program, State University of New York Health Sciences University, Brooklyn, NY, United States
| | - Caitlin Anne Moran
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Grady Healthcare System, Infectious Diseases Program, Atlanta, United States
| | - Howard Minkoff
- Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United States
| | - Michael W. Plankey
- Department of Medicine, Georgetown University, Washington, DC, United States
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Phyllis C. Tien
- Department of Medicine, University of California, San Francisco, CA, United States
- Department of Veterans Affairs, San Francisco, CA, United States
| | - Kathleen M. Weber
- Cook County Health/Hektoen Institute of Medicine, Chicago, IL, United States
| | - Deborah R. Gustafson
- Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United States
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Feinkohl I, Janke J, Slooter AJC, Winterer G, Spies C, Pischon T. Metabolic syndrome and the risk of postoperative delirium and postoperative cognitive dysfunction: a multi-centre cohort study. Br J Anaesth 2023:S0007-0912(23)00206-4. [PMID: 37344340 DOI: 10.1016/j.bja.2023.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Metabolic syndrome and its components are risk factors for cognitive impairment, but their contribution to perioperative neurocognitive disorders is unknown. We examined their associations with the risk of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in older patients. METHODS In 765 male and female participants aged ≥65 years, we measured preoperative metabolic parameters and screened for POD for 7 days or until discharge. POCD was defined through comparison of cognitive change on six neuropsychological tests with non-surgical controls. Multiple logistic regression analyses examined the association of metabolic parameters with risk of POD and POCD with adjustment for age, sex, and surgery type. RESULTS A total of 149 patients (19.5% of 765) developed POD and 53 (10.1% of 520 attendees) had POCD at 3 months. Patients with metabolic syndrome were at 1.85-fold higher risk of POD (95% confidence interval [CI] 1.26-2.70). Each 1 mmol L-1 higher high-density lipoprotein cholesterol (HDL-C) was associated with a 0.47-fold lower POD risk (95% CI 0.30-0.74). Each 1 kg m-2 higher body mass index (BMI) was associated with a 1.09-fold higher POCD risk (95% CI 1.02- 1.16). CONCLUSIONS Older surgical patients with metabolic syndrome were at increased risk of POD. Only reduced HDL-C was significantly associated with POD. For POCD, a higher preoperative BMI was identified as a risk factor. These findings add to mounting evidence of a distinct epidemiology of POD and POCD. Screening programmes taking advantage of HDL-C and BMI measurements and of metabolic interventions in reducing perioperative neurocognitive disorders should be evaluated. CLINICAL TRIAL REGISTRATION NCT02265263.
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Affiliation(s)
- Insa Feinkohl
- Witten/Herdecke University, Medical Biometry and Epidemiology Group, Witten, Germany; Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany.
| | - Jürgen Janke
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany; Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
| | - Arjen J C Slooter
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | - Georg Winterer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Spies
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany; Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany
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Díaz-Camargo E, Hernández-Lalinde J, Sánchez-Rubio M, Chaparro-Suárez Y, Álvarez-Caicedo L, Fierro-Zarate A, Gravini-Donado M, García-Pacheco H, Rojas-Quintero J, Bermúdez V. NHANES 2011-2014 Reveals Decreased Cognitive Performance in U.S. Older Adults with Metabolic Syndrome Combinations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5257. [PMID: 37047872 PMCID: PMC10093810 DOI: 10.3390/ijerph20075257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
A relationship between metabolic syndrome and cognitive impairment has been evidenced across research; however, conflicting results have been observed. A cross-sectional study was conducted on 3179 adults older than 60 from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to analyze the relationship between metabolic syndrome and cognitive impairment. In our results, we found that adults with abdominal obesity, high triglycerides, and low HDL cholesterol had 4.39 fewer points in the CERAD immediate recall test than adults without any metabolic syndrome factors [Beta = -4.39, SE = 1.32, 17.75 (1.36) vs. 22.14 (0.76)]. In addition, people with this metabolic syndrome combination exhibited 2.39 fewer points in the CERAD delayed recall test than those without metabolic syndrome criteria [Beta = -2.39, SE = 0.46, 4.32 (0.49) vs. 6.71 (0.30)]. It was also found that persons with high blood pressure, hyperglycemia, and low HDL-cholesterol levels reached 4.11 points less in the animal fluency test than people with no factors [Beta = -4.11, SE = 1.55, 12.67 (2.12) vs. 16.79 (1.35)]. These findings suggest that specific metabolic syndrome combinations are essential predictors of cognitive impairment. In this study, metabolic syndrome combinations that included obesity, fasting hyperglycemia, high triglycerides, and low HDL-cholesterol were among the most frequent criteria observed.
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Affiliation(s)
- Edgar Díaz-Camargo
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - Juan Hernández-Lalinde
- Facultad de Ciencias Básicas y Biomédicas, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - María Sánchez-Rubio
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - Yudy Chaparro-Suárez
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - Liseth Álvarez-Caicedo
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - Alexandra Fierro-Zarate
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia
| | - Marbel Gravini-Donado
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080001, Colombia
| | - Henry García-Pacheco
- Facultad de Medicina, Departamento de Cirugía, Universidad del Zulia, Hospital General del Sur, Dr. Pedro Iturbe, Maracaibo 4004, Venezuela
- Unidad de Cirugía para Obesidad y Metabolismo (UCOM), Maracaibo 4004, Venezuela
| | - Joselyn Rojas-Quintero
- Medicine, Pulmonary, Critical Care, and Sleep Medicine Department, Baylor College of Medicine, Houston, TX 77030, USA
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080001, Colombia
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9
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Lor YCM, Tsou MT, Tsai LW, Tsai SY. The factors associated with cognitive function among community-dwelling older adults in Taiwan. BMC Geriatr 2023; 23:116. [PMID: 36864383 PMCID: PMC9983251 DOI: 10.1186/s12877-023-03806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/07/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND This research aimed to investigate the associations of anthropometric measurements, physiological parameters, chronic disease comorbidities, and social and lifestyle factors with cognitive function amongst community-dwelling older adults in Taiwan. METHODS This was an observational, cross-sectional study involving 4,578 participants at least 65 years old, recruited between January 2008 and December 2018 from the Annual Geriatric Health Examinations Program. Cognitive function was assessed using the short portable mental state questionnaire (SPMSQ). Multivariable logistic regression was done to analyze the factors associated with cognitive impairment. RESULTS Among the 4,578 participants, 103 people (2.3%) with cognitive impairment were identified. Associated factors were age (odds ratio (OR) = 1.16, 95% confidence interval (CI) = 1.13,1.20), male gender (OR = 0.39, 95% CI = 0.21,0.72), diabetes mellitus (DM) (OR = 1.70, 95% CI = 1.03, 2.82), hyperlipidemia (OR = 0.47, 95% CI = 0.25, 0.89), exercise (OR = 0.44, 95% CI = 0.34, 0.56), albumin (OR = 0.37, 95% CI = 0.15, 0.88), and high-density lipoprotein (HDL) (OR = 0.98, 95% CI = 0.97, 1.00). Whereas waistline, alcohol intake in recent six months, and hemoglobin was not significantly associated with cognitive impairment (all p > 0.05). CONCLUSIONS Our findings suggested that people with older age and a history of DM had a higher risk of cognitive impairment. Male gender, a history of hyperlipidemia, exercise, a high albumin level, and a high HDL level seemed to be associated with a lower risk of cognitive impairment amongst older adults.
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Affiliation(s)
- You-Chen Mary Lor
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, No. 690, Section 2, Guangfu Road, East District, Hsinchu, 300, Taiwan
| | - Meng-Ting Tsou
- Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Nursing and Management, MacKay Junior College of Medicine, New Taipei City, Taiwan
| | - Li-Wei Tsai
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.,Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Szu-Ying Tsai
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, No. 690, Section 2, Guangfu Road, East District, Hsinchu, 300, Taiwan.
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10
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Dao L, Choi S, Freeby M. Type 2 diabetes mellitus and cognitive function: understanding the connections. Curr Opin Endocrinol Diabetes Obes 2023; 30:7-13. [PMID: 36385094 DOI: 10.1097/med.0000000000000783] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE OF REVIEW To review the connection between type 2 diabetes and cognitive dysfunction, including its epidemiology, potential mechanisms of pathophysiology, risk factors, possible prevention, and treatment considerations. RECENT FINDINGS Diabetes is a risk factor for mild cognitive decline, in addition to Alzheimer's disease and vascular dementia. Duration of diabetes, concomitant vascular or associated co-morbidities, hyper- and hypoglycemia may lead to worsening cognitive dysfunction. Unfortunately, there is a lack of evidence-based guidance on the prevention of cognitive dysfunction in the diabetes population. Studies of diabetes medications, including metformin, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose cotransporter-2 inhibitors (SGLT2) have shown some benefit with cardiovascular morbidity and may affect cognition. In the absence of clearly defined preventive tools, diabetes practice guidelines recommend annual cognitive screening as standard of care in adults with diabetes aged 65 years or older. SUMMARY People living with diabetes are at risk for significant decline in cognitive function. Epidemiology and risk factors are well defined. Prevention and treatment strategies are limited and require further study.
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Affiliation(s)
- Lisa Dao
- Division of Endocrinology, Diabetes and Metabolism, David Geffen School of Medicine UCLA
| | - Sarah Choi
- UCLA School of Nursing, Los Angeles, California, USA
| | - Matthew Freeby
- Division of Endocrinology, Diabetes and Metabolism, David Geffen School of Medicine UCLA
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11
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Gosalia J, Montgomery PS, Zhang S, Pomilla WA, Wang M, Liang M, Csiszar A, Ungvari Z, Yabluchanskiy A, Proctor DN, Gardner AW. Increased pulse wave velocity is related to impaired working memory and executive function in older adults with metabolic syndrome. GeroScience 2022; 44:2831-2844. [PMID: 35980564 PMCID: PMC9768088 DOI: 10.1007/s11357-022-00640-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/04/2022] [Indexed: 01/07/2023] Open
Abstract
Age-related vascular alterations promote the pathogenesis of vascular cognitive impairment (VCI). Cardiovascular risk factors that accelerate vascular aging exacerbate VCI. Metabolic syndrome (MetS) constitutes a cluster of critical cardiovascular risk factors (abdominal obesity, hypertension, elevated triglycerides, elevated fasting glucose, reduced HDL cholesterol), which affects nearly 37% of the adult US population. The present study was designed to test the hypotheses that MetS exacerbates cognitive impairment and that arterial stiffening moderates the association between cognitive dysfunction and MetS in older adults. MetS was defined by the NCEP ATP III guidelines. Cognitive function (digit span and trail-making tests) and brachial-ankle pulse wave velocity (baPWV; a non-invasive clinical measurement of arterial stiffness) were assessed in older adults with MetS and age- and sex-matched controls. Multiple linear regression models were applied to test for the main effects of MetS, baPWV, and their interaction on cognitive performance. Fifty-three participants with MetS (age: 68 ± 8 years) and 39 age-matched individuals without MetS (age: 66 ± 9 years) were enrolled into the study. In adjusted multivariable regression analyses of the digit span backward length score, both MetS (ß = 1.97, p = 0.048) and MetS by baPWV interaction (ß = - 0.001, p = 0.026) were significant predictors. In participants with MetS, higher baPWV was associated with poorer performance on digit span backward length score, a test of working memory (R = - 0.44, p = 0.0012), but there was no association in those without MetS (R = 0.035, p = 0.83). MetS was negatively associated with performance on the digit span backward length score, baPWV was negatively associated with multiple neuropsychological outcomes, and baPWV moderated the association between digit span backward length score and MetS, as individuals with both MetS and higher baPWV had the most impaired cognitive function. Our findings add to the growing body of evidence that individuals with MetS and higher baPWV may be prone to VCI.
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Affiliation(s)
- Jigar Gosalia
- Department of Kinesiology, Penn State University, University Park, PA, USA
| | - Polly S Montgomery
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Shangming Zhang
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - William A Pomilla
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA
| | - Ming Wang
- Department of Public Health Sciences, Penn State College of Medicine, 500 University DriveMail Code HP28, P.O. Box 850, Hershey, PA, 17033, USA
| | - Menglu Liang
- Department of Public Health Sciences, Penn State College of Medicine, 500 University DriveMail Code HP28, P.O. Box 850, Hershey, PA, 17033, USA
| | - Anna Csiszar
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment and Neurodegeneration Program, Oklahoma Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- The Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David N Proctor
- Department of Kinesiology, Penn State University, University Park, PA, USA
| | - Andrew W Gardner
- Department of Physical Medicine & Rehabilitation, Penn State College of Medicine, Hershey, PA, USA.
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12
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Kim YJ, Yeom HE. Threshold effects of body mass index on cognitive function and heterogeneity by sex and cardiovascular risk factors. Front Public Health 2022; 10:897691. [PMID: 35928477 PMCID: PMC9343732 DOI: 10.3389/fpubh.2022.897691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Disclosing the underlying relationship between body mass index (BMI) and cognitive decline is imperative for cognitive impairment prevention and early detection. Empirical studies have indicated the risk of abnormal BMI leading to cognitive impairment. However, the relative risk of underweight or overweight on cognitive function is obscure. This study investigated the asymmetric causal effect of BMI on cognitive decline below and above an unknown threshold and the heterogeneity in the threshold level and the magnitude of the threshold effect due to sex and cardiovascular risk factors. Methods This study used 2010–2018 panel data from the Korean Longitudinal Study of Aging that assessed sociodemographic and health-related trends in Korean middle-aged to older population. A generalized method of moments estimator of the panel threshold model was applied to estimate the potential nonlinear pattern between BMI and cognitive function. Results There was a threshold effect in the relationship between BMI and cognitive function. An increase in BMI below the threshold was associated with higher cognitive function, whereas a further increase in BMI above the threshold led to cognitive decline. The nonlinear pattern between BMI and cognitive function differed by sex and cardiovascular risk appearing more distinctively within men or the cardiovascular risk group. Conclusions The detrimental impact of being underweight or overweight on cognitive function is heterogeneous by sex or cardiovascular risk. For obese men or individuals with cardiovascular risk factors, maintaining adequate BMI should be highlighted to help prevent cognitive decline.
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Affiliation(s)
- Young-Joo Kim
- Department of Economics, Hongik University, Seoul, South Korea
| | - Hyun-E Yeom
- Department of Nursing, Chungnam National University, Daejeon, South Korea
- *Correspondence: Hyun-E Yeom
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13
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Ganci M, Suleyman E, Butt H, Ball M. Associations between self-reported psychological symptom severity and gut microbiota: further support for the microgenderome. BMC Psychiatry 2022; 22:307. [PMID: 35501777 PMCID: PMC9059404 DOI: 10.1186/s12888-022-03947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/14/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Research into the brain-gut-microbiota axis (BGMA) continues to reveal associations between gut microbiota (GM) and psychological symptom expression, inspiring new ways of conceptualising psychological disorders. However, before GM modulation can be touted as a possible auxiliary treatment option, more research is needed as inconsistencies in previous findings regarding these associations are prevalent. Additionally, the concept of the microgenderome, which proposes that GM may interact with sex hormones, has received limited attention in studies using human samples to date. However, such research has demonstrated sex specific associations between GM and psychological symptom expression. METHOD This cross-sectional retrospective study explores associations between GM species (identified through faecal microbial analysis) and symptom severity across four psychological domains (Depressive, Neurocognitive, Stress and Anxiety, and Sleep and Fatigue) for males (N = 1143) and females (N = 3467) separately. RESULTS GM species from several genera including Bifidobacterium, Clostridium, Enterococcus, and Leuconostoc were found to be differentially associated with psychological symptom severity for males and females. As such, the findings of the current study provide support for the concept of the microgenderome. CONCLUSION While further research is needed before their implementation in psychological treatment plans, the current findings suggest that modulation of GM at the species level may hold promise as auxiliary diagnostic or treatment options. These findings may give further insight into a client's presenting problem from a more holistic, multidisciplinary perspective. The clear sex divergence in associations between GM and symptoms give insight into sex discrepancies in susceptibility to psychological disorders.
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Affiliation(s)
- Michael Ganci
- Psychology Department, Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
| | - Emra Suleyman
- grid.1019.90000 0001 0396 9544Psychology Department, Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC 8001 Australia
| | - Henry Butt
- grid.1019.90000 0001 0396 9544Psychology Department, Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC 8001 Australia ,Bioscreen Yarraville (Aust) Pty Ltd, Melbourne, VIC Australia
| | - Michelle Ball
- grid.1019.90000 0001 0396 9544Psychology Department, Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC 8001 Australia
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14
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Zhang M, Zhu Y, Zhu Z. Research advances in the influence of lipid metabolism on cognitive impairment. IBRAIN 2022; 10:83-92. [PMID: 38682015 PMCID: PMC11045198 DOI: 10.1002/ibra.12018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 05/01/2024]
Abstract
Cognitive impairment (CI) is a mental disorder related to cognition and understanding, which is mainly categorized into mild CI and senile dementia. This disease is associated with multiple factors, such as chronic brain injury, aging, chronic systemic disease, mental state, and psychological factors. However, the pathological mechanism of CI remains unclear; it is usually associated with such underlying diseases as diabetes and hyperlipidemia. It has been demonstrated that abundant lipid metabolism indexes in the human body are closely related to CI, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein, and so forth. As a crucial risk factor for CI, hyperlipidemia is of great significance in the occurrence and development of CI. However, the specific correlation between dyslipidemia and CI is still not fully elucidated. Besides, the efficacy of lipid-lowering drugs in the prophylaxis and treatment of CI has not been clarified. In this study, relevant advances in the influence of lipid metabolism disorders in CI will be reviewed, in an attempt to explore the effect of mediating blood lipid levels on the prophylaxis and treatment of CI, thus providing a reference for its clinical management.
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Affiliation(s)
- Min Zhang
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Suining Central HospitalSuiningSichuanChina
| | - Yu‐Hang Zhu
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Zhao‐Qiong Zhu
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
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15
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Lv Z, Che L, Du Y, Yu J, Su E, Liu H, Chen D. Mechanism of Mongolian Medicine Eerdun Wurile in Improving Postoperative Cognitive Dysfunction Through Activation of the PI3K Signaling Pathway. Front Neurosci 2022; 15:769759. [PMID: 35095392 PMCID: PMC8798410 DOI: 10.3389/fnins.2021.769759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To study the effect of Eerdun Wurile (EW), a traditional Mongolian medicine, on the cognitive function of rats by activating the IRS-PI3K-AKT-GLUT4 pathway in an animal model of postoperative cognitive dysfunction (POCD). Methods Fifty clean-grade adults Sprague Dawley (SD) male rats were assigned to one of five groups: (1) a control group with no anesthesia (Group C), (2) a POCD model group with anesthesia only (Group P), (3) POCD group with low-dose EW treated (Group L), (4) a POCD group with high-dose EW treated (Group H), and (5) a POCD model group with dexmedetomidine treated (Group D) for positive control. The study started 7 days after all rats had acclimated to housing. Rats were trained in the Morris Water Maze navigation 5 days before surgery. All rats underwent the same maze for navigation and spatial exploration experiments on the preoperative day 1 and postoperative days 1, 3, 5, and their learning and memory abilities were assessed. At the end of the water maze experiment, rats were sacrificed to obtain hippocampal tissue. The mRNA levels of IRS-2, PI3K, AKT, and GLUT4 were measured in the hippocampus by real-time PCR, and the expression of IRS-2, PI3K, AKT, and GLUT4 protein in the hippocampus was determined by Western blotting to investigate the potential mechanisms at the molecular level. Results Compared to control Group C, Group P, L, H, and D showed prolonged escape latency (P < 0.05) and decreased number of times to cross the platform (P < 0.05) at 1, 3 and 5 days after surgery. Compared to Group P, Group L, H, and D showed a decrease in escape latency with an increased number of crossing the platform at all-time points after surgery (P < 0.05). Within individual P, L, H, and D groups, escape latencies decreased (P < 0.05) and the number of times that the platform was crossed increased (P < 0.05) between postoperative days 3 and 5 compared to postoperative 1 day. Compared to Group C, the mRNA expression of IRS-2, PI3K, AKT and GLUT4 in the hippocampus of P, L, H, and D groups were decreased (P < 0.05). Compared to Group P, IRS-2, PI3K, AKT, and GLUT4 in the hippocampus of L, H, and D groups were increased (P < 0.05). Compared with Group D, the expression levels of IRS-2 and AKT in both L and H groups were higher. The expression level of PI3K in Group L was also higher (P < 0.05) vs Group D. The expression of AKT mRNA in Group H was higher than in Group L (P < 0.05). Compared to Group C, the p-IRS-2/IRS-2 ratio in the hippocampus of Group P was higher than that of Group C (P < 0.05). Compared to Group P, the ratios of p-IRS-2/IRS-2 in Group L, Group H, and Group D were lower, and the ratios of the p-PI3K/PI3K, p-AKT/AKT, and p-GLUT4/GLUT4 were higher (P < 0.05). Conclusion Administration of EW showed the effect on the signaling pathway in rats with POCD. The therapeutic effect was better in the low-dose group. This could be related to the insulin downstream signal molecule PI3K and the IRS-PI3K-AKT-GLUT4 signaling pathway.
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Affiliation(s)
- Zhixin Lv
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Limuge Che
- Medical Innovation Center for Nationalities, Inner Mongolia Medical University, Hohhot, China
| | - Yiri Du
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
- *Correspondence: Yiri Du,
| | - Jianshe Yu
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Enboer Su
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Hui Liu
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Dongmei Chen
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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16
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George ES, Sood S, Daly RM, Tan SY. Is there an association between non-alcoholic fatty liver disease and cognitive function? A systematic review. BMC Geriatr 2022; 22:47. [PMID: 35016619 PMCID: PMC8753832 DOI: 10.1186/s12877-021-02721-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is represented as the most common liver disease worldwide. NAFLD is associated with metabolic risk factors underpinned by insulin resistance, inflammation and endothelial dysfunction, leading to extrahepatic changes in central nervous diseases such as cognitive impairment, Alzheimer's disease and dementia. The aim of the review is to explore the association between NAFLD and cognitive function. METHODS Using the PRISMA guidelines, a systematic electronic literature search was conducted in four databases: MEDLINE, PsychINFO, Embase and CINAHL from inception until March 2021. Neuropsychological tests utilised within each study were grouped into relevant cognitive domains including 'general cognition', 'reasoning', 'mental speed, attention and psychomotor speed', 'memory and learning', 'language', 'visuospatial perception' and 'ideas, abstraction, figural creations and mental flexibility'. RESULTS Eleven observational studies that involved 7978 participants with a mean age of 51 years were included. Those with NAFLD had poor cognitive performance in three cognitive domains, including 'general cognition', 'mental speed, attention and psychomotor speed', and 'ideas, abstraction, figural creations and mental flexibility'. CONCLUSION The observed results from the 11 included studies showed that NAFLD was associated with lower cognitive performance across several domains. However, studies conducted to date are limited to observational designs and are heterogeneous with varying diagnostic tools used to assess cognitive function. TRIAL REGISTRATION PROSPERO Registration: CRD42020161640 .
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Affiliation(s)
- Elena S George
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, 3220, Australia.
| | - Surbhi Sood
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, 3220, Australia
| | - Robin M Daly
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, 3220, Australia
| | - Sze-Yen Tan
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, 3220, Australia
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Rizzo MR, Di Meo I, Polito R, Auriemma MC, Gambardella A, di Mauro G, Capuano A, Paolisso G. Cognitive impairment and type 2 diabetes mellitus: Focus of SGLT2 inhibitors treatment. Pharmacol Res 2022; 176:106062. [PMID: 35017046 DOI: 10.1016/j.phrs.2022.106062] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/09/2023]
Abstract
Gliflozins are a novel class of oral anti-diabetic drugs, acting as inhibitors of sodium-glucose co-transporters (SGLTs) through the proximal convoluted tubules (PCT) and intestinal epithelium. The sodium-glucose co-transporters 2 (SGLT2) are mainly expressed in S1 and S2 segments of the proximal convoluted tubule in the kidneys. Clinical guidelines recommend their use especially in Type 2 Diabetes mellitus (T2DM) patients with vascular complications and/or heart failure highlighting the importance of sodium-glucose co-transporter 2 inhibitors (SGLT2i) pleiotropic effects. Interestingly, cognitive decline is a widely recognized complication of T2DM and, in addition, to clarify its pathophysiology, there is an urgent need to understand how and if diabetes therapies can control diabetes-related cognitive dysfunction. At the time, although SGLT2 proteins are present in the Central Nervous System (CNS), the SGLT2i effects on cognitive impairments remain partly unknown. In pre-clinical studies, SGLT2i ameliorates cognitive dysfunction in obese and T2DM mice, reducing oxidative stress, neuroinflammation and improving neuronal plasticity and mitochondrial brain pathway. In addition, SGLT2i could bring back mTOR to a physiological state of activation, stopping neurodegenerative diseases' onset or progression. Instead, clinical studies on T2DM-related cognitive dysfunction treated by SGLT2i are much more limited. For these reasons, further studies are needed to better elucidate if SGLT2i therapy can affect T2DM-related cognitive decline. In this scenario, this review aims to summarize the state of knowledge on the role of SGLT2i in T2DM-related cognitive dysfunction and stimulate new clinical trials.
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Affiliation(s)
- Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences - University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
| | - Irene Di Meo
- Department of Advanced Medical and Surgical Sciences - University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Rita Polito
- Department of Advanced Medical and Surgical Sciences - University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Maria Chiara Auriemma
- Department of Advanced Medical and Surgical Sciences - University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Antonio Gambardella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Gabriella di Mauro
- Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine - Section of Pharmacology "L. Donatelli", University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences - University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
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18
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Short cognitive screening in elderlies as a part of advanced pharmaceutical care in Slovak community pharmacies - The pilot study KOGNIMET-SK. EUROPEAN PHARMACEUTICAL JOURNAL 2022. [DOI: 10.2478/afpuc-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The aim of this study is to evaluate the implementation of a simple, easy-to-use cognitive screening test in the pharmaceutical care of elderly patients (aged 60 years and over) in community pharmacies and to test whether cognitive decline is associated with metabolic syndrome (MetS).
Current research has reported the increasing prevalence of MetS with age and indicated a link between cardiovascular risk factors and impairment of cognitive functions. We hypothesized that the short cognitive test realised in pharmaceutical care in community pharmacies could help identify risk groups of patients with potential cognitive decline. Because of the increasing pressure on primary care, collaboration between community pharmacists and general practitioners is essential, especially in preventive programmes and regarding chronically ill patients.
The study included 222 elderly patients aged 60 years and over reached between February 2018 and February 2019 in 16 community pharmacies in Slovakia. Criteria for the classification of MetS were used, following the International Diabetes Federation Worldwide Definition of MetS (2005) for European populations. Cognitive performance was evaluated using the Slovak version of the Montreal Cognitive Assessment. The scale range of the MoCA test is 0–30 points, and the cut-off for cognitive impairment is ≤ 24 points.
Our outcomes show that the presence of metabolic syndrome only slightly contributes to the impairment of cognitive functions of patients receiving routine pharmaceutical care in community pharmacies. Cognitive assessment might be an important tool for identifying risk groups of patients that would benefit from a specific approach within the framework of pharmaceutical care.
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Zhang L, Gu LY, Dai SB, Zheng R, Jin CY, Fang Y, Yang WY, Tian J, Yin XZ, Zhao GH, Pu JL, Zhang BR, Yan YP, Chen Y. Associations of Body Mass Index-Metabolic Phenotypes with Cognitive Decline in Parkinson's Disease. Eur Neurol 2021; 85:24-30. [PMID: 34689144 DOI: 10.1159/000517538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Growing evidence suggests important effects of body mass index (BMI) and metabolic status on neurodegenerative diseases. However, the roles of BMI and metabolic status on cognitive outcomes in Parkinson's disease (PD) may vary and are yet to be determined. METHODS In total, 139 PD patients from the whole PD cohort in Parkinson's Progression Markers Initiative database underwent complete laboratory measurements, demographic and anthropometric parameters at baseline, and were enrolled in this study. Further, they were categorized into 4 different BMI-metabolic status phenotypes using Adult Treatment Panel-III criteria. Motor and cognition scales at baseline and longitudinal changes after a 48-month follow-up were compared among the 4 groups. Repeated-measure linear mixed models were performed to compare PD-related biomarkers among BMI-metabolic status phenotypes across time. RESULTS We found that PD patients in the metabolically unhealthy normal weight group showed more cognitive decline in global cognition and visuospatial perception after a 48-month follow-up than those in the other 3 groups (p < 0.05). No difference was found in motor scales among different BMI-metabolic status phenotypes. Finally, compared to the metabolically healthy normal weight group, the metabolically healthy obesity group had lower CSF Aβ42 and serum neurofilament levels in repeated-measure linear mixed models adjusting for age, gender, APOE e4 carrier status, and years of education (p = 0.031 and 0.046, respectively). CONCLUSION The MUNW phenotype was associated with a rapid cognitive decline in PD.
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Affiliation(s)
- Liang Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lu-Yan Gu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shao-Bing Dai
- Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ran Zheng
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chong-Yao Jin
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Fang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wen-Yi Yang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Tian
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xin-Zhen Yin
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Guo-Hua Zhao
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jia-Li Pu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Bao-Rong Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ya-Ping Yan
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Chen
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Abstract
PURPOSE OF REVIEW Metabolic syndrome (MetS) is a cluster of cardiovascular disease risk factors that are related to several adverse health outcomes, including poor cognitive function. This review seeks to summarize and critically review select recent findings on the association between MetS and cognition. RECENT FINDINGS MetS was associated with lower domain-specific and global cognitive function in most cross-sectional studies, but findings from longitudinal studies are not consistent. The associations varied depending on age, sex, cognitive test, genetic susceptibility, and the duration of follow-up in prospective studies. MetS was associated with a higher risk of mild cognitive impairment (MCI) and progression from MCI to dementia, particularly vascular dementia. Among MetS components, high blood pressure, high waist circumference, and hyperglycemia were the strongest predictors of cognitive function. MetS is associated with higher risk of cognitive impairment. Research is needed on how preventing or treating MetS affects cognition.
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21
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Copper, Iron, Selenium and Lipo-Glycemic Dysmetabolism in Alzheimer's Disease. Int J Mol Sci 2021; 22:ijms22179461. [PMID: 34502369 PMCID: PMC8431716 DOI: 10.3390/ijms22179461] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of the present review is to discuss traditional hypotheses on the etiopathogenesis of Alzheimer's disease (AD), as well as the role of metabolic-syndrome-related mechanisms in AD development with a special focus on advanced glycation end-products (AGEs) and their role in metal-induced neurodegeneration in AD. Persistent hyperglycemia along with oxidative stress results in increased protein glycation and formation of AGEs. The latter were shown to possess a wide spectrum of neurotoxic effects including increased Aβ generation and aggregation. In addition, AGE binding to receptor for AGE (RAGE) induces a variety of pathways contributing to neuroinflammation. The existing data also demonstrate that AGE toxicity seems to mediate the involvement of copper (Cu) and potentially other metals in AD pathogenesis. Specifically, Cu promotes AGE formation, AGE-Aβ cross-linking and up-regulation of RAGE expression. Moreover, Aβ glycation was shown to increase prooxidant effects of Cu through Fenton chemistry. Given the role of AGE and RAGE, as well as metal toxicity in AD pathogenesis, it is proposed that metal chelation and/or incretins may slow down oxidative damage. In addition, selenium (Se) compounds seem to attenuate the intracellular toxicity of the deranged tau and Aβ, as well as inhibiting AGE accumulation and metal-induced neurotoxicity.
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22
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Depressive symptoms and 5-year incident metabolic syndrome among older adults. Sci Rep 2021; 11:14842. [PMID: 34290362 PMCID: PMC8295297 DOI: 10.1038/s41598-021-94503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Little is known regarding the association between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. This study aimed to examine the association of depressive symptoms with MetS and its components among Chinese elderly. Based on whether they showed depressive symptoms at baseline, 262 age-gender-matched participants from a community-based cohort study were included. The presence of depressive symptoms was measured using the nine-item Patient Health Questionnaire (PHQ-9). MetS was defined according to the Adult Treatment Panel III of the National Cholesterol Education Program. Linear regression and logistic regression analyses were performed to assess associations of depressive symptoms with MetS and its components. The incidence of MetS among the participants with depressive symptoms at baseline was 15.27% (20/131). The association of the presence of depressive symptoms with MetS was significant (odds ratio [OR] = 2.53, 95% confidence intervals [CI] = 1.07, 5.95). There was a negative association between depressive symptoms and hypertension (OR = 0.04, 95% CI = 0.002, 0.98). The change in mean arterial pressure varies approximately 1.03 mmHg with a 1-point change in PHQ-9 score. In this study, baseline depressive symptoms were associated with subsequent MetS. The presence of depressive symptoms was negatively associated with elevated mean arterial pressure.
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23
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Wang M, Li Y, Cong L, Hou T, Luo Y, Shi L, Chang L, Zhang C, Wang Y, Wang X, Du Y, Qiu C. High-density lipoprotein cholesterol and brain aging amongst rural-dwelling older adults: a population-based magnetic resonance imaging study. Eur J Neurol 2021; 28:2882-2892. [PMID: 34031948 DOI: 10.1111/ene.14939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Current evidence supports the involvement of lipids in brain aging. A range of serum lipids is explored in association with brain structure and cognitive function amongst rural-dwelling older adults. METHODS This population-based cross-sectional study included 184 rural-dwelling adults (age ≥ 65 years, 39.1% women) in Shandong, China. In 2014-2016, data on demographics, lifestyle, health conditions and serum lipids were collected. Volumes of gray matter, white matter, ventricles, hippocampus and white matter hyperintensity were automatically estimated on brain magnetic resonance imaging. Global cognitive function was assessed with the Mini-Mental State Examination (MMSE), and mild cognitive impairment (MCI) was defined according to Petersen's criteria. Data were analyzed using the general linear regression, logistic regression and mediation models. RESULTS Of the 184 participants, 47 were defined with MCI. Low high-density lipoprotein cholesterol (HDL-C; <1.55 vs. ≥1.55 mmol/l) was significantly associated with reduced volumes of total white matter (multi-adjusted β = -9.77, 95% confidence interval -19.48-0.06) and hippocampus (-0.23, -0.46-0.01), a lower MMSE score (-1.49, -2.67-0.31) and a higher likelihood of MCI (multi-adjusted odds ratio 3.21, 95% confidence interval 1.42-7.29). The mediation effects of structural brain measures on the associations between a low level of HDL-C and MMSE score or MCI were not statistically significant (p > 0.05). CONCLUSIONS This study suggests that low HDL-C may be involved in structural brain aging and cognitive dysfunction amongst rural-dwelling older adults in China, but the association of low HDL-C with cognitive aging phenotypes appears not to be mediated by brain structure.
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Affiliation(s)
- Mingqi Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China
| | - Yuanjing Li
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet Stockholm University, Stockholm, Sweden
| | - Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, Guangdong, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, Guangdong, China.,Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Liguo Chang
- Liaocheng Third People's Hospital, Liaocheng, Shandong, China
| | - Chuanchen Zhang
- Department of Radiology, Liaocheng People's Hospital and Liaocheng Brain Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, Liaocheng, Shandong, China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, China.,Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet Stockholm University, Stockholm, Sweden
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24
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Rojas M, Chávez-Castillo M, Pirela D, Parra H, Nava M, Chacín M, Angarita L, Añez R, Salazar J, Ortiz R, Durán Agüero S, Gravini-Donado M, Bermúdez V, Díaz-Camargo E. Metabolic Syndrome: Is It Time to Add the Central Nervous System? Nutrients 2021; 13:nu13072254. [PMID: 34208833 PMCID: PMC8308252 DOI: 10.3390/nu13072254] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 12/28/2022] Open
Abstract
Metabolic syndrome (MS) is a set of cardio-metabolic risk factors that includes central obesity, hyperglycemia, hypertension, and dyslipidemias. The syndrome affects 25% of adults worldwide. The definition of MS has evolved over the last 80 years, with various classification systems and criteria, whose limitations and benefits are currently the subject of some controversy. Likewise, hypotheses regarding the etiology of MS add more confusion from clinical and epidemiological points of view. The leading suggestion for the pathophysiology of MS is insulin resistance (IR). IR can affect multiple tissues and organs, from the classic “triumvirate” (myocyte, adipocyte, and hepatocyte) to possible effects on organs considered more recently, such as the central nervous system (CNS). Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) may be clinical expressions of CNS involvement. However, the association between MCI and MS is not understood. The bidirectional relationship that seems to exist between these factors raises the questions of which phenomenon occurs first and whether MCI can be a precursor of MS. This review explores shared pathophysiological mechanisms between MCI and MS and establishes a hypothesis of a possible MCI role in the development of IR and the appearance of MS.
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Affiliation(s)
- Milagros Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela; (M.R.); (D.P.); (H.P.); (M.N.); (J.S.)
| | | | - Daniela Pirela
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela; (M.R.); (D.P.); (H.P.); (M.N.); (J.S.)
| | - Heliana Parra
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela; (M.R.); (D.P.); (H.P.); (M.N.); (J.S.)
| | - Manuel Nava
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela; (M.R.); (D.P.); (H.P.); (M.N.); (J.S.)
| | - Maricarmen Chacín
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 08002, Colombia;
| | - Lissé Angarita
- Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad Andrés Bello, Sede Concepción 4260000, Chile;
| | - Roberto Añez
- Departamento de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela; (M.R.); (D.P.); (H.P.); (M.N.); (J.S.)
| | - Rina Ortiz
- Posgrado, Carrera de Medicina, Universidad Católica de Cuenca, Cantón de Cuenca 010101, Ecuador;
| | - Samuel Durán Agüero
- Facultad de Ciencias Para el Cuidado de la Salud, Universidad San Sebastián, Los Leones 8420524, Chile;
| | - Marbel Gravini-Donado
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla 080002, Colombia;
| | - Valmore Bermúdez
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia;
| | - Edgar Díaz-Camargo
- Facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Cúcuta 540006, Colombia;
- Correspondence:
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25
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Dimache AM, Șalaru DL, Sascău R, Stătescu C. The Role of High Triglycerides Level in Predicting Cognitive Impairment: A Review of Current Evidence. Nutrients 2021; 13:2118. [PMID: 34203094 PMCID: PMC8234148 DOI: 10.3390/nu13062118] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/13/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022] Open
Abstract
The burden of cognitive disorders is huge and still growing, however the etiology and the degree of cognitive impairment vary considerably. Neurodegenerative and vascular mechanisms were most frequently assessed in patients with dementia. Recent studies have shown the possible involvement of triglycerides levels in cognitive function through putative mechanisms such as brain blood barrier dysfunction or amyloid metabolism imbalance, but not all research in the field found this association. Several clinical studies evaluated the relationship between different forms of cognitive decline and levels of serum triglycerides, independent of other cardiovascular risk factors. This review focuses on the role of triglycerides in cognitive decline, cerebral amyloidosis and vascular impairment. Considering that the management of hypertriglyceridemia benefits from lifestyle modification, diet, and specific drug therapy, future studies are requested to appraise the triglycerides-cognitive impairment relationship.
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Affiliation(s)
- Alina Mihaela Dimache
- Neurology Outpatient Clinic, Department of Chronic Diseases, Hospital of Chronic Diseases Târgu Frumos, 705300 Iași, Romania;
| | - Delia Lidia Șalaru
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iași, Romania; (R.S.); (C.S.)
- Institute of Cardiovascular Diseases, 700503 Iasi, Romania
| | - Radu Sascău
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iași, Romania; (R.S.); (C.S.)
- Institute of Cardiovascular Diseases, 700503 Iasi, Romania
| | - Cristian Stătescu
- Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa, 700115 Iași, Romania; (R.S.); (C.S.)
- Institute of Cardiovascular Diseases, 700503 Iasi, Romania
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26
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Kendig MD, Leigh SJ, Morris MJ. Unravelling the impacts of western-style diets on brain, gut microbiota and cognition. Neurosci Biobehav Rev 2021; 128:233-243. [PMID: 34153343 DOI: 10.1016/j.neubiorev.2021.05.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 03/23/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023]
Abstract
The steady rise in the prevalence of obesity has been fostered by modern environments that reduce energy expenditure and encourage consumption of 'western'-style diets high in fat and sugar. Obesity has been consistently associated with impairments in executive function and episodic memory, while emerging evidence indicates that high-fat, high-sugar diets can impair aspects of cognition within days, even when provided intermittently. Here we review the detrimental effects of diet and obesity on cognition and the role of inflammatory and circulating factors, compromised blood-brain barrier integrity and gut microbiome changes. We next evaluate evidence for changing risk profiles across life stages (adolescence and ageing) and other populations at risk (e.g. through maternal obesity). Finally, interventions to ameliorate diet-induced cognitive deficits are discussed, including dietary shifts, exercise, and the emerging field of microbiome-targeted therapies. With evidence that poor diet and obesity impair cognition via multiple mechanisms across the human lifespan, the challenge for future research is to identify effective interventions, in addition to diet and exercise, to prevent and ameliorate adverse effects.
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27
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Feinkohl I, Kozma P, Borchers F, van Montfort SJT, Kruppa J, Winterer G, Spies C, Pischon T. Contribution of IQ in young adulthood to the associations of education and occupation with cognitive ability in older age. BMC Geriatr 2021; 21:346. [PMID: 34090365 PMCID: PMC8180039 DOI: 10.1186/s12877-021-02290-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Studies suggest that a higher education and occupation are each associated with a higher late-life cognitive ability, but their inter-relationships in their association with cognitive ability and the contribution of peak IQ in young adulthood (‘pre-morbid IQ’) often remain unclear. Methods Cross-sectional analysis of 623 participants aged ≥65 years of the BioCog study. Education was coded according to the International Standard Classification of Education (ISCED; range 1 to 6). Occupation was coded as ‘semi/unskilled’, ‘skilled manual’, ‘skilled non-manual’, ‘managerial’, ‘professional’. A summary score of global ability (‘g’) was constructed from six cognitive tests. Pre-morbid IQ was estimated from vocabulary. The Geriatric Depression Scale assessed symptoms of depression. Age- and sex-adjusted analyses of covariance were performed. Results Education (partial eta2 0.076; p < 0.001) and occupation (partial eta2 = 0.037; p < 0.001) were each significantly associated with g. For education, the association was attenuated but remained statistically significant when pre-morbid IQ was controlled for (partial eta2 0.036; p < 0.001) and was unchanged with additional adjustment for depression (partial eta2 0.037; p < 0.001). For occupation, the association with g was no longer significant when pre-morbid IQ (partial eta2 = 0.015; p = 0.06) and depression (partial eta2 = 0.011; p = 0.18) were entered as covariates in separate steps. When education and occupation were entered concurrently into the fully adjusted model, only education was independently associated with g (partial eta2 0.030; p < 0.001; occupation, p = 0.93). Conclusion While a higher education and a higher occupation were each associated with a higher late-life cognitive ability, only for education some unique contribution to cognitive ability remained over and above its relationship with pre-morbid IQ, depression, and occupation. Further research is needed to address whether a longer time spent in education may promote late-life cognitive ability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02290-y.
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Affiliation(s)
- Insa Feinkohl
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.
| | - Petra Kozma
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedrich Borchers
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Jochen Kruppa
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Spies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle Str. 10, 13092, Berlin, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany.,Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Berlin, Germany
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Cardiometabolic Risk Factors leading to Diabetes Mellitus among the Young (YOD) from the 8 th Philippine National Nutrition Survey. J ASEAN Fed Endocr Soc 2021; 36:12-24. [PMID: 34177083 PMCID: PMC8214347 DOI: 10.15605/jafes.036.01.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/16/2021] [Indexed: 02/08/2023] Open
Abstract
Objectives This study looked into the prevalence of diabetes mellitus (DM) and risks for cardiovascular and metabolic diseases among young adults with diabetes (age 20-44 years old, YOD) and late-onset DM (≥45 years old, LOD) in Filipinos. Methodology Weighted data from 546,580 adults with DM from the 8th Philippine National Nutrition and Health Survey (NNHeS) were utilized. Differences in sociodemographic, anthropometric, clinical profiles and metabolic risks were compared between YOD and LOD. Results The aggregated prevalence of DM is 5.43% (95%CI, 5.10–5.79), YOD were 2.64% (95% CI, 2.32–3.00) and LOD 9.85% (95%CI, 9.18–10.56). Mean age of YOD was 37,6 years, LOD 59,9 years. The YOD were mostly males (56%), with higher BMI (26.24 kg/m2 vs 25 kg/m2, p=0.002), lower mean SBP (122.41±19.17 mmHg vs 135.45±22.47 mmHg, p<0.001), more daily smokers (23% vs 14%), and alcoholic beverage drinkers (39% vs 31%). Physical activity was similar between groups (44% vs 51%, p=0.078). However, average total caloric intake (1776.78±758.38 kcal vs 1596.88±639.16 kcal, p=0.023) and carbohydrate intake (306.13±142.16 grams vs 270.53±104.74 g, p=0.014) were higher in YOD. Dietary carbohydrate proportions were higher than recommended (69% vs 68%) for both groups. Young Filipinos had higher risk to develop diabetes when they are obese II (22% vs 12%), current drinker (56% vs 37%), and current smoker (28% vs 18%). Eighty percent of YOD and LOD had metabolic syndrome (MetS). With every unit increase in age and fat intake, the odds of having MetS were raised by 5.4% (95%CI 1%–10%, p=0.029) and 1.6% (95%CI 0.04%-3%, p=0.044), respectively. Conclusion Early-onset diabetes mellitus appears to be driven by obesity, MetS and social behaviors. Modifiable risk factors can be improved early to decrease hazards to develop cardiometabolic complications.
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Wang X, Ji L, Tang Z, Ding G, Chen X, Lv J, Chen Y, Li D. The association of metabolic syndrome and cognitive impairment in Jidong of China: a cross-sectional study. BMC Endocr Disord 2021; 21:40. [PMID: 33663435 PMCID: PMC7934472 DOI: 10.1186/s12902-021-00705-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Metabolic syndrome (Mets) is prevalent in the general population and has been reported to be an independent risk factor for cognitive impairment. This study aimed to investigate the association of Mets with the risk of cognitive impairment. METHODS We studied 5854 participants from the Jidong community. Cognitive function was assessed by the Mini-Mental State of Examination (MMSE) scale. Mets was diagnosed according to the International Diabetes Federation criteria. We used logistic regression analysis to investigate the association of metabolic syndrome with the risk of cognitive impairment. RESULT Among the 5854 adults included in the study, the age mean (SD) of age was 44 (13.57) years, and 2916 (50.34%) were male. There was a higher (56.03%) cognitive impairment incidence rate among participants with Mets than among those without Mets. In addition, there was a significant association between Mets and cognitive impairment (OR: 2.39, 95% CI: 2.00-2.86, P < 0.05) after adjusting for potential confounders, including age, gender, education level, marital status, smoking and alcohol consumption status. Regarding the 5 Mets components, abdominal obesity and elevated blood pressure were associated with the risk of Mets (OR: 1.36, 95% CI: 1.09-1.70, P < 0.001; OR: 1.32, 95% CI: 1.07-1.63, P < 0.05). Moreover, the strongest statistical correlation (adjusted OR: 1.86, 95% CI: 1.22-2.83, P < 0.05) was found when the number of Mets components was three. CONCLUSION Our study suggested that Mets was associated with cognitive impairment and that abdominal obesity and hypertension were associated with an increased risk of cognitive impairment.
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Affiliation(s)
- Xiaohui Wang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Long Ji
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Zhaoyang Tang
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Guoyong Ding
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Xueyu Chen
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Jian Lv
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Yanru Chen
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China
| | - Dong Li
- Department of Epidemiology, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Changcheng Road, Taian, 271016, P.R. China.
- The Second Affiliated Hospital of Shandong First Medical University, 706 Taisan Street, Taian, 271000, China.
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Rotblatt LJ, Aiken-Morgan AT, Marsiske M, Horgas AL, Thomas KR. Do Associations Between Vascular Risk and Mild Cognitive Impairment Vary by Race? J Aging Health 2021; 35:898264320984357. [PMID: 33497299 PMCID: PMC8310897 DOI: 10.1177/0898264320984357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: Given prevalence differences of mild cognitive impairment (MCI) among Black and white older adults, this study aimed to examine whether overall vascular risk factor (VRF) burden and individual VRF associations with amnestic (aMCI) and nonamnestic (naMCI) MCI status varied by Black/white race. Methods: Participants included 2755 older adults without dementia from the ACTIVE study. Comprehensive neuropsychological criteria were used to classify cognitively normal, aMCI, and naMCI. VRFs were primarily defined using subjective report and medication data. Multinomial logistic regression was run predicting MCI subtype. Results: Greater overall VRF burden, high cholesterol, and obesity evinced greater odds of naMCI in Black participants than whites. Across participants, diabetes and hypertension were associated with increased odds of aMCI and naMCI, respectively. Discussion: Results may reflect known systemic inequities on dimensions of social determinants of health for Black older adults. Continued efforts toward examining underlying mechanisms contributing to these findings are critical.
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Affiliation(s)
- Lindsay J. Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Ann L. Horgas
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL
| | - Kelsey R. Thomas
- Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
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Kim YJ, Kim SM, Jeong DH, Lee SK, Ahn ME, Ryu OH. Associations between metabolic syndrome and type of dementia: analysis based on the National Health Insurance Service database of Gangwon province in South Korea. Diabetol Metab Syndr 2021; 13:4. [PMID: 33407809 PMCID: PMC7789546 DOI: 10.1186/s13098-020-00620-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease. However, the relationship between metabolic syndrome and dementia has remained controversial. Using nationwide population cohort data, we investigated the association between metabolic syndrome and dementia, according to the dementia type. METHODS We analyzed data of 84,144 individuals, in the aged group of more than 60 years, between January 1, 2009, to December 31, 2009, at Gangwon province by using the information of the (Korean) National Health Insurance Service. After eight years of gap, in 2017, we investigated the relationship between metabolic syndrome and dementia. We classified Dementia either as dementia of the Alzheimer type (AD) or vascular dementia (VD). AD and VD were defined as per the criteria of International Classification of Disease, Tenth Revision, Clinical Modification codes. Multiple logistic regression analyses examined the associations between metabolic syndrome or five metabolic syndrome components and dementia. Analyses included factors like age, sex, smoking, alcohol, physical inactivity, previous stroke, and previous cardiac disease. RESULTS Metabolic syndrome was associated with AD (OR = 11.48, 95% CI 9.03-14.59), not with VD. Each of five components of metabolic syndrome were also associated with AD. (high serum triglycerides: OR = 1.87, 95% CI 1.60-2.19; high blood pressure: OR = 1.85, 95% CI 1.55-2.21; high glucose: OR = 1.77, 95% CI 1.52-2.06; abdominal obesity: OR = 1.88, 95% CI 1.57-2.25; low serum high-density lipoprotein cholesterol: OR = 1.91, 95% CI 1.63-2.24) However, among components of metabolic syndrome, only the high glucose level was associated with VD. (OR = 1.26, 95% CI 1.01-1.56) body mass index (BMI), fasting glucose, and smoking were also associated with AD. (BMI: OR = 0.951, 95% CI 0.927-0.975; fasting glucose: OR = 1.003, 95% CI 1.001-1.005; smoking: OR = 1.020, 95% CI 1.003-1.039) A history of the previous stroke was associated with both AD and VD. (AD: OR = 1.827, 95% CI 1.263-2.644; VD: OR 2.775, 95% CI 1.747-4.406) CONCLUSIONS: Metabolic syndrome was associated with AD but not with VD. Patients with metabolic syndrome had an 11.48 times more likeliness to develop AD compared to those without metabolic syndrome. VD was associated only with several risk factors that could affect the vascular state rather than a metabolic syndrome. We suggested that the associations between metabolic syndrome and dementia would vary depending on the type of dementia.
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Affiliation(s)
- Yeo Jin Kim
- Department of Neurology, Hallym University-Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
| | - Sang Mi Kim
- Department of Big Data Analytics, Ewha Woman’s University, Seoul, Republic of Korea
| | - Dae Hyun Jeong
- Research Institute for Gangwon, Chuncheon, Gangwon-do Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, Hallym University-Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
| | - Moo-Eob Ahn
- Department of Emergency Medicine, Hallym University-Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gangwon-do Republic of Korea
| | - Ohk-Hyun Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University-Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-do 24253 Republic of Korea
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Sun Q, Tang L, Zeng Q, Gu M. Assessment for the Correlation Between Diabetic Retinopathy and Metabolic Syndrome: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2021; 14:1773-1781. [PMID: 33911890 PMCID: PMC8075313 DOI: 10.2147/dmso.s265214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE In this study, we explored the correlation between diabetic retinopathy (DR) and metabolic syndrome (MetS) among diabetes mellitus (DM) patients. METHODS Logistic regression analysis was utilized to test the effects of MetS and its indicators on the incidence of DR and vision-related functional burden. The spline smoothing functions of continuous indicators of MetS were used to establish the logistic generalized additive model (GAM). The effective degree of freedom (EDF) =1 was served as a sign of linear relationship. EDF>1 was a sign of a more complex association between MetS and DR. RESULTS The proportion of difficulties of looking for objects on the crowded shelves in the DR group was higher than that in the non-DR group (19.40 vs 12.10, P<0.05). Elevated fasting glucose (Glu) and blood pressure levels were related to the vision-related functional burden. The risk of DR development increased by 6% [95% confidence interval (CI): 1.03-1.09, P<0.001] and 1% (95% CI: 1.01-1.02, P=0.004) per 1 unit increase in Glu and systolic blood pressure (SBP) of DM patients, respectively. In the univariate GAM, Glu had a linear effect on DR (EDF=1, P<0.001) with a positive correlation after controlling SBP. And there was a nonlinear correlation between SBP and DR after controlling Glu (EDF=2.44, P=0.024). CONCLUSION Both Glu and blood pressure were associated with the occurrence of DR and vision-related functional burden. Controlling the levels of Glu and blood pressure may reduce the risk of DR and vision loss among DM patients.
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Affiliation(s)
- Qing Sun
- Department of Clinical Nutrition, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People’s Republic of China
- Department of Endocrinology, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People’s Republic of China
| | - Liang Tang
- Department of Endocrinology, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People’s Republic of China
| | - Qiurong Zeng
- Department of Endocrinology, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People’s Republic of China
| | - Mingjun Gu
- Department of Endocrinology, Fuling Center Hospital of Chongqing City, Chongqing, 408000, People’s Republic of China
- Correspondence: Mingjun Gu Department of Endocrinology, Fuling Center Hospital of Chongqing City, No. 2 Fuling District, Gaosuntang Road, Chongqing, 408000, People’s Republic of ChinaTel +86 13996860971 Email
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Blevins BL, Vinters HV, Love S, Wilcock DM, Grinberg LT, Schneider JA, Kalaria RN, Katsumata Y, Gold BT, Wang DJJ, Ma SJ, Shade LMP, Fardo DW, Hartz AMS, Jicha GA, Nelson KB, Magaki SD, Schmitt FA, Teylan MA, Ighodaro ET, Phe P, Abner EL, Cykowski MD, Van Eldik LJ, Nelson PT. Brain arteriolosclerosis. Acta Neuropathol 2021; 141:1-24. [PMID: 33098484 PMCID: PMC8503820 DOI: 10.1007/s00401-020-02235-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022]
Abstract
Brain arteriolosclerosis (B-ASC), characterized by pathologic arteriolar wall thickening, is a common finding at autopsy in aged persons and is associated with cognitive impairment. Hypertension and diabetes are widely recognized as risk factors for B-ASC. Recent research indicates other and more complex risk factors and pathogenetic mechanisms. Here, we describe aspects of the unique architecture of brain arterioles, histomorphologic features of B-ASC, relevant neuroimaging findings, epidemiology and association with aging, established genetic risk factors, and the co-occurrence of B-ASC with other neuropathologic conditions such as Alzheimer's disease and limbic-predominant age-related TDP-43 encephalopathy (LATE). There may also be complex physiologic interactions between metabolic syndrome (e.g., hypertension and inflammation) and brain arteriolar pathology. Although there is no universally applied diagnostic methodology, several classification schemes and neuroimaging techniques are used to diagnose and categorize cerebral small vessel disease pathologies that include B-ASC, microinfarcts, microbleeds, lacunar infarcts, and cerebral amyloid angiopathy (CAA). In clinical-pathologic studies that factored in comorbid diseases, B-ASC was independently associated with impairments of global cognition, episodic memory, working memory, and perceptual speed, and has been linked to autonomic dysfunction and motor symptoms including parkinsonism. We conclude by discussing critical knowledge gaps related to B-ASC and suggest that there are probably subcategories of B-ASC that differ in pathogenesis. Observed in over 80% of autopsied individuals beyond 80 years of age, B-ASC is a complex and under-studied contributor to neurologic disability.
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Affiliation(s)
- Brittney L Blevins
- Department of Neuroscience, University Kentucky, Lexington, KY, 40536, USA
| | - Harry V Vinters
- Department of Pathology and Laboratory Medicine, David Geffen SOM at UCLA and Ronald Reagan UCLA Medical Center, Los Angeles, CA, 90095-1732, USA
| | - Seth Love
- University of Bristol and Southmead Hospital, Bristol, BS10 5NB, UK
| | - Donna M Wilcock
- Sanders-Brown Center on Aging, Department of Neuroscience, University Kentucky, Lexington, KY, 40536, USA
| | - Lea T Grinberg
- Department of Neurology and Pathology, UCSF, San Francisco, CA, USA
- Global Brain Health Institute, UCSF, San Francisco, CA, USA
- LIM-22, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Julie A Schneider
- Departments of Neurology and Pathology, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Rajesh N Kalaria
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Yuriko Katsumata
- Sanders-Brown Center on Aging, Department of Biostatistics, University Kentucky, Lexington, KY, 40536, USA
| | - Brian T Gold
- Sanders-Brown Center on Aging, Department of Neuroscience, University Kentucky, Lexington, KY, 40536, USA
| | - Danny J J Wang
- Laboratory of FMRI Technology (LOFT), USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Samantha J Ma
- Laboratory of FMRI Technology (LOFT), USC Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Lincoln M P Shade
- Sanders-Brown Center on Aging, Department of Biostatistics, University Kentucky, Lexington, KY, 40536, USA
| | - David W Fardo
- Sanders-Brown Center on Aging, Department of Biostatistics, University Kentucky, Lexington, KY, 40536, USA
| | - Anika M S Hartz
- Sanders-Brown Center on Aging, Department of Pharmacology and Nutritional Sciences, University Kentucky, Lexington, KY, 40536, USA
| | - Gregory A Jicha
- Sanders-Brown Center on Aging, Department of Neurology, University Kentucky, Lexington, KY, 40536, USA
| | | | - Shino D Magaki
- Department of Pathology and Laboratory Medicine, David Geffen SOM at UCLA and Ronald Reagan UCLA Medical Center, Los Angeles, CA, 90095-1732, USA
| | - Frederick A Schmitt
- Sanders-Brown Center on Aging, Department of Neurology, University Kentucky, Lexington, KY, 40536, USA
| | - Merilee A Teylan
- Department of Epidemiology, University Washington, Seattle, WA, 98105, USA
| | | | - Panhavuth Phe
- Sanders-Brown Center on Aging, University Kentucky, Lexington, KY, 40536, USA
| | - Erin L Abner
- Sanders-Brown Center on Aging, Department of Epidemiology, University Kentucky, Lexington, KY, 40536, USA
| | - Matthew D Cykowski
- Departments of Pathology and Genomic Medicine and Neurology, Houston Methodist Hospital, Houston, TX, 77030, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, Department of Neuroscience, University Kentucky, Lexington, KY, 40536, USA
| | - Peter T Nelson
- Sanders-Brown Center on Aging, Department of Pathology, University of Kentucky, Lexington, KY, 40536, USA.
- Rm 311 Sanders-Brown Center on Aging, University of Kentucky, 800 S. Limestone Avenue, Lexington, KY, 40536, USA.
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van Beers M, Gosker HR, Janssen DJA, Cleutjens FAHM, Franssen FME, van Boxtel MPJ, Wouters EF, Ponds RWHM, Schols AMWJ. Cognitive performance in relation to metabolic disturbances in patients with COPD. Clin Nutr 2020; 40:2061-2067. [PMID: 33041090 DOI: 10.1016/j.clnu.2020.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/18/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Cognitive impairment (CI) and metabolic abnormalities, including the metabolic syndrome (MetS) and sarcopenia, are more prevalent in COPD patients compared to controls without diagnosed lung disease. Because earlier studies have shown these metabolic abnormalities may affect cognitive performance, this study investigated whether cognitive performance is more impaired in subgroups of COPD patients with MetS or sarcopenia. METHODS Cognitive performance patterns of 170 COPD patients referred for pulmonary rehabilitation (53.5% male, 63.4 ± 9.4 years, FEV1 54.5 ± 22.7% predicted) were compared between COPD subgroups stratified by presence of MetS and sarcopenia. Cognitive performance was assessed using a detailed neuropsychological test battery, which measured psychomotor speed (Stroop Color-Word Test, Concept Shifting Test, Letter-Digit Substitution Test), planning (Behavioral Assessment of the Dysexecutive Syndrome), working memory (Visual-Verbal Learning Test, Digit Span), verbal memory (Visual-Verbal Learning Test) and cognitive flexibility (Stroop Color-Word Test, Concept Shifting Test). MetS was determined according to the NCEP ATP-III criteria. Sarcopenia was determined based on decreased appendicular lean mass by dual-energy x-ray absorptiometry and impaired physical performance by 6-min walking distance. RESULTS MetS was observed in 54.7% and sarcopenia in 30.0% of COPD patients. The prevalence of general CI was not different between patients with and without MetS (30.4% and 39.0%, respectively) or those with and without sarcopenia (34.0% and 34.5%, respectively, both p > 0.05). Domain-specific cognitive performance was not different between metabolic subgroups, but those with sarcopenia displayed a lower prevalence of CI on verbal memory than those without (21.7% and 29.7%, respectively, p = 0.011). Only the digit span (working memory) subtest was significantly different between metabolic subgroups, in favor of those without MetS (p = 0.017). CONCLUSION Cognitive performance was not affected more in COPD patients with sarcopenia or MetS.
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Affiliation(s)
- Martijn van Beers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6202 AZ Maastricht, the Netherlands.
| | - Harry R Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6202 AZ Maastricht, the Netherlands
| | - Daisy J A Janssen
- Department of Research and Development, CIRO, P.O. Box 4009, 6080 AA Haelen, the Netherlands; Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6202 AZ Maastricht, the Netherlands
| | - Fiona A H M Cleutjens
- Department of Research and Development, CIRO, P.O. Box 4009, 6080 AA Haelen, the Netherlands
| | - Frits M E Franssen
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6202 AZ Maastricht, the Netherlands; Department of Research and Development, CIRO, P.O. Box 4009, 6080 AA Haelen, the Netherlands
| | - Martin P J van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Maastricht University, 6202 AZ Maastricht, the Netherlands
| | - Emiel F Wouters
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6202 AZ Maastricht, the Netherlands; Department of Research and Development, CIRO, P.O. Box 4009, 6080 AA Haelen, the Netherlands
| | - Rudolf W H M Ponds
- Department of Psychiatry and Neuropsychology and Limburg Brain Injury Center, School for Mental Health and Neurosciences, Maastricht University, 6202 AZ Maastricht, the Netherlands
| | - Annemie M W J Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6202 AZ Maastricht, the Netherlands
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Feinkohl I, Janke J, Slooter AJC, Winterer G, Spies C, Pischon T. Plasma leptin, but not adiponectin, is associated with cognitive impairment in older adults. Psychoneuroendocrinology 2020; 120:104783. [PMID: 32623019 DOI: 10.1016/j.psyneuen.2020.104783] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 04/28/2020] [Accepted: 06/19/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Leptin and adiponectin are adipose-tissue derived hormones primarily involved in glucose, lipid, and energy metabolism, inflammation, and atherosclerosis. Both adipokines may cross the blood-brain barrier but evidence on their roles in cognitive impairment is limited and conflicting. Here, we determined associations of plasma adipokine concentration with cognitive impairment in older adults. METHODS Cross-sectional analysis of baseline data from 669 participants aged ≥65 years of the Biomarker Development for Postoperative Cognitive Impairment in the Elderly (BioCog) study were recruited 2014-2017 at study sites in Berlin, Germany and Utrecht, the Netherlands. Cognitive impairment was defined as the lowest tertile of a cognitive summary score derived from six neuropsychological tests. RESULTS After adjustment for age, sex, fasting, BMI, diabetes, hypertension, cerebrovascular disease, and coronary heart disease, higher leptin concentrations and a higher leptin/adiponectin ratio (LAR) were associated with a higher odds of cognitive impairment (OR per 1 SD higher leptin concentration, 1.33; 95 % CI 1.05, 1.69; p = 0.02; OR per 1 SD higher LAR, 1.26; 95 % CI 1.01, 1.57; p = 0.04). Sensitivity analyses determined that these findings were driven by the non-obese group (BMI < 30 kg/m2), whereas leptin and LAR were not associated with cognitive impairment in the obese group (BMI ≥ 30 kg/m2). Soluble leptin receptor, leptin/soluble leptin receptor ratio, total adiponectin and high-molecular weight adiponectin concentrations were each not associated with impairment. CONCLUSIONS With leptin as a known promoter of atherosclerosis and inflammation, our findings point to a pathogenic role of leptin in age-related cognitive impairment that may be limited to non-obese individuals and warrants further investigation.
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Affiliation(s)
- Insa Feinkohl
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany.
| | - Jürgen Janke
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany
| | - Arjen J C Slooter
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Universiteitsweg 98, 3584 CG Utrecht, the Netherlands
| | - Georg Winterer
- Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Claudia Spies
- Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany; Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany; MDC/BIH Biobank, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), and Berlin Institute of Health (BIH), Robert-Rössle Str. 10, D-13092 Berlin, Germany
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Tomassoni D, Martinelli I, Moruzzi M, Micioni Di Bonaventura MV, Cifani C, Amenta F, Tayebati SK. Obesity and Age-Related Changes in the Brain of the Zucker Lepr fa/fa Rats. Nutrients 2020; 12:E1356. [PMID: 32397542 PMCID: PMC7284640 DOI: 10.3390/nu12051356] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/02/2020] [Accepted: 05/06/2020] [Indexed: 02/08/2023] Open
Abstract
Metabolic syndrome (MetS) is an association between obesity, dyslipidemia, hyperglycemia, hypertension, and insulin resistance. A relationship between MetS and vascular dementia was hypothesized. The purpose of this work is to investigate brain microanatomy alterations in obese Zucker rats (OZRs), as a model of MetS, compared to their counterparts lean Zucker rats (LZRs). 12-, 16-, and 20-weeks-old male OZRs and LZRs were studied. General physiological parameters and blood values were measured. Immunochemical and immunohistochemical techniques were applied to analyze the brain alterations. The morphology of nerve cells and axons, astrocytes and microglia were investigated. The blood-brain barrier (BBB) changes occurring in OZRs were assessed as well using aquaporin-4 (AQP4) and glucose transporter protein-1 (GLUT1) as markers. Body weight gain, hypertension, hyperglycemia, and hyperlipidemia were found in OZRs compared to LZRs. In the frontal cortex and hippocampus, a decrease of neurons was noticeable in the older obese rats in comparison to their age-matched lean counterparts. In OZRs, a reduction of neurofilament immunoreaction and gliosis was observed. The BBB of older OZRs revealed an increased expression of AQP4 likely related to the development of edema. A down-regulation of GLUT1 was found in OZRs of 12 weeks of age, whereas it increased in older OZRs. The behavioral analysis revealed cognitive alterations in 20-week-old OZRs. Based on these results, the OZRs may be useful for understanding the mechanisms through which obesity and related metabolic alterations induce neurodegeneration.
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Affiliation(s)
- Daniele Tomassoni
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, Italy;
| | - Ilenia Martinelli
- School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, Italy; (I.M.); (M.V.M.D.B.); (F.A.)
| | - Michele Moruzzi
- Department of Medicine, University of Leipzig, Liebigstraße 21, 04103 Leipzig, Germany;
| | | | - Carlo Cifani
- School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, Italy; (I.M.); (M.V.M.D.B.); (F.A.)
| | - Francesco Amenta
- School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, Italy; (I.M.); (M.V.M.D.B.); (F.A.)
| | - Seyed Khosrow Tayebati
- School of Pharmacy, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, Italy; (I.M.); (M.V.M.D.B.); (F.A.)
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Borshchev YY, Uspensky YP, Galagudza MM. Pathogenetic pathways of cognitive dysfunction and dementia in metabolic syndrome. Life Sci 2019; 237:116932. [PMID: 31606384 DOI: 10.1016/j.lfs.2019.116932] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/27/2019] [Accepted: 10/02/2019] [Indexed: 12/13/2022]
Abstract
The prevalence of dementia worldwide is growing at an alarming rate. A number of studies and meta-analyses have provided evidence for increased risk of dementia in patients with metabolic syndrome (MS) as compared to persons without MS. However, there are some reports demonstrating a lack of association between MS and increased dementia risk. In this review, taking into account the potential role of individual MS components in the pathogenesis of MS-related cognitive dysfunction, we considered the underlying mechanisms in arterial hypertension, diabetes mellitus, dyslipidemia, and obesity. The pathogenesis of dementia in MS is multifactorial, involving both vascular injury and non-ischemic neuronal death due to neurodegeneration. Neurodegenerative and ischemic lesions do not simply coexist in the brain due to independent evolution, but rather exacerbate each other, leading to more severe consequences for cognition than would either pathology alone. In addition to universal mechanisms of cognitive dysfunction shared by all MS components, other pathogenetic pathways leading to cognitive deficits and dementia, which are specific for each component, also play a role. Examples of such component-specific pathogenetic pathways include central insulin resistance and hypoglycemia in diabetes, neuroinflammation and adipokine imbalance in obesity, as well as arteriolosclerosis and lipohyalinosis in arterial hypertension. A more detailed understanding of cognitive disorders based on the recognition of underlying molecular mechanisms will aid in the development of new methods for prevention and treatment of devastating cognitive problems in MS.
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Affiliation(s)
- Yury Yu Borshchev
- Institute of Experimental Medicine, Almazov National Medical Research Center, Saint Petersburg, Russian Federation
| | - Yury P Uspensky
- Department of Faculty Therapy, Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation
| | - Michael M Galagudza
- Laboratory of Digital and Display Holography, ITMO University, Russian Federation, Saint Petersburg, Russian Federation.
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Decrease in HDL-C is Associated with Age and Household Income in Adults from the Korean National Health and Nutrition Examination Survey 2017: Correlation Analysis of Low HDL-C and Poverty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183329. [PMID: 31509977 PMCID: PMC6765955 DOI: 10.3390/ijerph16183329] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/27/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022]
Abstract
A low serum high-density lipoproteins-cholesterol (HDL-C) level is a risk factor of cardiovascular disease and dementia. On the other hand, no study has elucidated the correlation between household income and the HDL-C level in the adult population. In the present study, 5535 subjects (20–80 year-old individuals) were selected from the Korean national health and nutrition examination survey 2017 (KNHANES VII-2, n = 2469 men, n = 3066 women). They were classified into five levels of household income grades ranging from one (the lowest) to five (the highest). They were also classified according to the HDL-C level: category 1 (<40 mg/dL, n = 943), category 2 (40–49 mg/dL, n = 1764), category 3 (50–59 mg/dL, n = 1572), category 4 (60–69 mg/dL, n = 820), and category 5 (≥70 mg/dL, n = 436). Generally, in both genders, a higher HDL-C level is associated with a larger percentage of income grades 4 and 5. Moreover, the lowest HDL-C group showed the largest percentage of income grade 1. In both groups, a significant increase in the average income grade was associated with a concomitant increase in the HDL-C level (men, p = 0.03, women, p < 0.001). In the low HDL-C category, a lower income grade is associated directly with a lower HDL-C level, which suggests that poverty is associated directly with a low HDL-C. Women showed a 3.3-fold higher incidence of dementia than men did at later-life. The sharp decrease in HDL-C in the female group older than 50 was accompanied by a dramatic increase in the incidence of dementia. However, the male group showed a relatively mild decrease in the HDL-C level after mid-life and weak elevation in the incidence of dementia. In conclusion, in both genders, the lower income group showed a larger prevalence of low-HDL-C levels. The decrease in HDL-C after middle age was strongly associated with the considerable increase in dementia in later-life.
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Péterfalvi Á, Németh N, Herczeg R, Tényi T, Miseta A, Czéh B, Simon M. Examining the Influence of Early Life Stress on Serum Lipid Profiles and Cognitive Functioning in Depressed Patients. Front Psychol 2019; 10:1798. [PMID: 31447737 PMCID: PMC6691174 DOI: 10.3389/fpsyg.2019.01798] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background Early childhood adversity is a strong predictor of the development of major depressive disorder (MDD), but not all depressed patients experience early life stress (ELS). Cardio-metabolic diseases and cognitive deficits often coincide in MDD and worsen its course and outcome. Adverse childhood experiences have been associated with elevated risk for cardiovascular disease (CVD), but little is known on the impact of ELS on cardiovascular risk factors in MDD. Here, we examined MDD patients with and without ELS to explore the effects of ELS on serum lipid and lipoprotein levels and on cognitive performances of the patients. Methods Participants with a mean age of 35 years (18–55 years) were recruited from the university mental health clinic and general community. Three groups, matched in age, gender and lifestyle were examined: MDD patients with ELS (n = 21), MDD patients without ELS (n = 21), and healthy controls (n = 20). The following CVD risk factors were assessed: serum lipids (total cholesterol, triglycerides, high- and low-density lipoproteins), body mass index and exercise in a typical week. MDD severity was measured by the Beck Depression Inventory. Childhood Trauma Questionnaire was used to assess early life adversities. Executive functions and attentional processes were assessed by the Wisconsin Card Sorting and Conners’ Continuous Performance tests. Results Major depressive disorder patients with ELS had higher serum triglyceride and lower HDL-cholesterol concentrations compared to MDD patients without ELS. Linear regression analysis revealed that the severity of ELS had a significant negative association with HDL-cholesterol levels and significant positive associations with the serum levels of TG and TC/HDL-cholesterol index. We also found significant associations between some specific trauma types and lipid profiles. Finally, we could detect significant associations between depression severity and specific domains of the cognitive tests as well as between lipid profiles and certain domains of the Wisconsin Card Sorting Test. However, we could not detect any association between the severity of ELS and cognitive performance. Conclusion After controlling for depressive symptom severity and lifestyle variables, ELS was found to be a strong predictor of serum lipid alterations. Several, inter-correlated pathways may mediate the undesirable effects of ELS on the course and outcome of MDD.
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Affiliation(s)
- Ágnes Péterfalvi
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nándor Németh
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Róbert Herczeg
- Bioinformatics Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Attila Miseta
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Boldizsár Czéh
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Maria Simon
- Neurobiology of Stress Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.,Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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Rosado-Pérez J, Aguiñiga-Sánchez I, Santiago-Osorio E, Mendoza-Núñez VM. Effect of Sechium edule var. nigrum spinosum (Chayote) on Oxidative Stress and Pro-Inflammatory Markers in Older Adults with Metabolic Syndrome: An Exploratory Study. Antioxidants (Basel) 2019; 8:antiox8050146. [PMID: 31137783 PMCID: PMC6562705 DOI: 10.3390/antiox8050146] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/15/2019] [Accepted: 05/22/2019] [Indexed: 12/12/2022] Open
Abstract
Metabolic syndrome (MetS) is a risk factor for cognitive deterioration and frailty in older adults. In this regard it has been shown that oxidative stress (OxS) and chronic inflammation are involved in the pathophysiology of these alterations. Harmless antioxidant and anti-inflammatory therapeutic alternatives have been proposed, such as the consumption of Sechium edule (chayote), but the evidence is inconclusive. For this reason, an exploratory study of a single group chosen by convenience sampling, including 12 older adults, with an average age of 71 ± 6 years (10 women and 2 men) with a diagnosis of MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) criteria. This exploratory study aimed to determine the effect of the consumption of the dried fruit powder supplement of Sechium edule var. nigrum spinosum (500 mg, 3 times per day) for six weeks on the markers of OxS in elderly adults with MetS. All participants’ OxS markers were measured before and after treatment. There was a statistically significant decrease in the concentration of lipoperoxides (baseline, 0.289 ± 0.04 vs. post-treatment, 0.234 ± 0.06 μmol/L, p < 0.05), together with a significant increase in total antioxidant status (baseline, 0.97 ± 0.18 vs. post-treatment, 1.2 ± 0.12 mmol/L, p < 0.05). In this sense, the oxidative stress index showed a statistically significant decrease (baseline, 1.7 ± 0.78 vs. post-treatment, 0.75 ± 0.87, p < 0.05). A statistically significant decrease in the concentration of TNF-α after treatment was also found (baseline, 5.3 ± 1.4 vs. post-treatment, 3.5 ± 1.3, p < 0.05).Our findings suggest that the consumption of the dry fruit of Sechium edule has an antioxidant and anti-inflammatory effect in older adults with metabolic syndrome.
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Affiliation(s)
- Juana Rosado-Pérez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico.
| | - Itzen Aguiñiga-Sánchez
- Hematopoiesis and Leukemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico.
| | - Edelmiro Santiago-Osorio
- Hematopoiesis and Leukemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico.
| | - Víctor Manuel Mendoza-Núñez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico.
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