切换至 "中华医学电子期刊资源库"

中华肥胖与代谢病电子杂志 ›› 2024, Vol. 10 ›› Issue (03) : 206 -212. doi: 10.3877/cma.j.issn.2095-9605.2024.03.008

综述

减重手术治疗肥胖症相关认知障碍的研究进展
高昊雯, 王桂琦, 庞利云, 张新昕, 谷敬锋()   
  1. 050000 石家庄,河北医科大学第一医院胃肠病诊疗一科(减重与代谢性疾病)
  • 收稿日期:2023-10-07 出版日期:2024-08-30
  • 通信作者: 谷敬锋

Research progress of bariatric surgery for the treatment of obesity-related cognitive impairment

Haowen Gao, Guiqi Wang, Liyun Pang, Xinxin Zhang, Jingfeng Gu()   

  1. Department of Gastroenterology (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Received:2023-10-07 Published:2024-08-30
  • Corresponding author: Jingfeng Gu
引用本文:

高昊雯, 王桂琦, 庞利云, 张新昕, 谷敬锋. 减重手术治疗肥胖症相关认知障碍的研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(03): 206-212.

Haowen Gao, Guiqi Wang, Liyun Pang, Xinxin Zhang, Jingfeng Gu. Research progress of bariatric surgery for the treatment of obesity-related cognitive impairment[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(03): 206-212.

肥胖不仅增加高血压、2型糖尿病、心血管疾病等多种疾病的患病风险,也与认知功能障碍的发生密切相关。目前,减重手术已被证实为治疗肥胖的有效手段,其对认知功能的影响也备受关注。越来越多的研究显示减重手术对改善肥胖相关认知功能障碍具有积极作用。然而肥胖、减重手术与肥胖相关认知障碍之间的关系复杂,关联机制及改善情况尚未得到充分而准确的阐述。本文根据近年来的相关研究,阐述肥胖相关认知障碍的发生机制,描述现有治疗方法,综述减重手术改善肥胖相关认知障碍的研究进展,旨在为治疗肥胖相关认知障碍提供更多依据,为改善肥胖患者认知功能提供合适的治疗方案。

Obesity not only increases the risk of a variety of diseases such as hypertension, type 2 diabetes, and cardiovascular disease but is also strongly associated with the development of cognitive dysfunction. Currently, bariatric surgery has been proven to be an effective treatment for obesity, and its impact on cognitive function is of great concern. A growing body of research is showing the positive effects of bariatric surgery in improving obesity-related cognitive dysfunction. However, the relationship between obesity, bariatric surgery and cognitive impairment is complex and the mechanisms and improvements have not been fully and accurately described. Based on the relevant studies in recent years, this paper describes the occurrence mechanism of obesity-related cognitive impairment, describes the existing treatment methods, and reviews the research progress of bariatric surgery to improve obesity-related cognitive impairment, aiming to provide more bases for the treatment of obesity-related cognitive impairment, and provide more appropriate treatment programs to improve the cognitive function of patients with obesity.

图1 肥胖引起相关认知功能障碍的可能机制、减重手术改善肥胖相关认知障碍的可能机制及目前针对肥胖相关认知障碍的治疗方法
[1]
Chen K, Shen Z, Gu W, et al. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults [J]. Diabetes Obes Metab, 2023, 25(11): 3390-3399.
[2]
Burns CI, Boghokian A, Soti V. Obesity and Postoperative Cognitive Dysfunction: A Curious Association [J]. Cureus, 2023, 15(7): e42436.
[3]
马微波, 刘悦文, 于莹, 等. 高热量饮食诱导的肠道菌群失调与认知功能障碍关系的研究进展 [J]. 实用老年医学, 2021, 35(04): 405-409.
[4]
Mina T, Yew YW, Ng HK, et al. Adiposity impacts cognitive function in Asian populations: an epidemiological and Mendelian Randomization study [J]. Lancet Reg Health West Pac, 2023, 33: 100710.
[5]
Morledge MD, Pories WJ. Bariatric surgery and cognitive impairment [J]. Obesity (Silver Spring), 2021, 29(8): 1239-1241.
[6]
杨斌, 张丽芝, 陈琦芳, 等. 减重手术改善肥胖症认知功能障碍及其机制 [J]. 生物化学与生物物理进展, 2023, 50(10): 2373-2384.
[7]
Xu J, Gao H, Zhang L, et al. Melatonin alleviates cognition impairment by antagonizing brain insulin resistance in aged rats fed a high-fat diet [J]. J Pineal Res, 2019, 67(2): e12584.
[8]
唐倩, 黄琪, 梁凤霞. 肥胖引起的胰岛素抵抗对认知障碍的影响机制研究进展 [J]. 华中科技大学学报(医学版), 2022, 51(05): 718-724.
[9]
安金, 李小旋, 任艳艳, 等. 2型糖尿病致认知功能障碍的危险因素 [J]. 国际神经病学神经外科学杂志, 2018, 45(03): 323-327.
[10]
华嵘暄, 高晗, 王博雅, 等. 菌-肠-脑轴与血脑屏障通透性的相关性研究进展 [J]. 世界华人消化杂志, 2022, 30(02): 100-108.
[11]
Hsu TM, Kanoski SE. Blood-brain barrier disruption: mechanistic links between Western diet consumption and dementia [J]. Front Aging Neurosci, 2014, 6: 88.
[12]
Lochhead JJ, Yang J, Ronaldson PT, et al. Structure, Function, and Regulation of the Blood-Brain Barrier Tight Junction in Central Nervous System Disorders [J]. Front Physiol, 2020, 11: 914.
[13]
Zhang Y, Huang B, Yang W, et al. Correlations Between Endocrine Hormones and Cognitive Function in Patients with Obesity: a Cross-sectional Study [J]. Obes Surg, 2022, 32(7): 2299-2308.
[14]
赵筱汐, 麻微微. 肥胖、炎症与认知功能的相关性研究进展 [J]. 生理科学进展, 2018, 49(04): 299-304.
[15]
Olsthoorn L, Vreeken D, Kiliaan AJ. Gut Microbiome, Inflammation, and Cerebrovascular Function: Link Between Obesity and Cognition [J]. Front Neurosci, 2021, 15: 761456.
[16]
Lee YS, Kim JW, Osborne O, et al. Increased adipocyte O2 consumption triggers HIF-1α, causing inflammation and insulin resistance in obesity [J]. Cell, 2014, 157(6): 1339-1352.
[17]
Hata M, Andriessen EMMA, Hata M, et al. Past history of obesity triggers persistent epigenetic changes in innate immunity and exacerbates neuroinflammation [J]. Science, 2023, 379(6627): 45-62.
[18]
Bruce-Keller AJ, Salbaum JM, Luo M, et al. Obese-type gut microbiota induce neurobehavioral changes in the absence of obesity [J]. Biol Psychiatry, 2015, 77(7): 607-615.
[19]
Saji N, Niida S, Murotani K, et al. Analysis of the relationship between the gut microbiome and dementia: a cross-sectional study conducted in Japan [J]. Sci Rep, 2019, 9(1): 1008.
[20]
冷慧层, 刘璇, 尹榕. 肥胖相关认知障碍发病机制研究进展 [J]. 中国现代医药杂志, 2021, 23(05): 101-104.
[21]
Agrawal R, Noble E, Vergnes L, et al. Dietary fructose aggravates the pathobiology of traumatic brain injury by influencing energy homeostasis and plasticity [J]. J Cereb Blood Flow Metab, 2016, 36(5): 941-953.
[22]
Ferreiro AL, Choi J, Ryou J, et al. Gut microbiome composition may be an indicator of preclinical Alzheimer's disease [J]. Sci Transl Med, 2023, 15(700): e2984.
[23]
Knight SP, Laird E, Williamson W, et al. Obesity is associated with reduced cerebral blood flow - modified by physical activity [J]. Neurobiol Aging, 2021, 105: 35-47.
[24]
Amen DG, Wu J, George N, et al. Patterns of Regional Cerebral Blood Flow as a Function of Obesity in Adults [J]. J Alzheimers Dis, 2020, 77(3):1331-1337.
[25]
Anand SS, Friedrich MG, Lee DS, et al. Canadian Alliance of Healthy Hearts and Minds (CAHHM) and the Prospective Urban and Rural Epidemiological (PURE) Study Investigators. Evaluation of Adiposity and Cognitive Function in Adults [J]. JAMA Netw Open, 2022, 5(2): e2146324.
[26]
Shen Q, Chen Z, Zhao F, et al. Reversal of prolonged obesity-associated cerebrovascular dysfunction by inhibiting microglial Tak1 [J]. Nat Neurosci, 2020, 23(7): 832-841.
[27]
Zheng Y, Chen ZY, Ma WJ, et al. B Vitamins Supplementation Can Improve Cognitive Functions and May Relate to the Enhancement of Transketolase Activity in A Rat Model of Cognitive Impairment Associated with High-fat Diets [J]. Curr Med Sci, 2021, 41(5): 847-856.
[28]
Chang EH, Chavan SS, Pavlov VA. Cholinergic Control of Inflammation, Metabolic Dysfunction, and Cognitive Impairment in Obesity-Associated Disorders: Mechanisms and Novel Therapeutic Opportunities [J]. Front Neurosci, 2019, 13: 263.
[29]
Mansouri S, Salari AA, Abedi A, et al. Melatonin treatment improves cognitive deficits by altering inflammatory and neurotrophic factors in the hippocampus of obese mice [J]. Physiol Behav, 2022, 254: 113919.
[30]
Cai Y, Liu P, Zhou X, et al. Probiotics therapy show significant improvement in obesity and neurobehavioral disorders symptoms [J]. Front Cell Infect Microbiol, 2023, 13: 1178399.
[31]
Naomi R, Teoh SH, Rusli RNM, et al. Elateriospermum tapos Yoghurt as a Therapeutic Intervention for Obesity-Associated Cognitive Impairments and Anxiety-like Behaviour in a High Fat Diet Maternal Obese Rat Model [J]. Nutrients, 2023, 15(10): 2312.
[32]
Veronese N, Facchini S, Stubbs B, et al. Weight loss is associated with improvements in cognitive function among overweight and obese people: A systematic review and meta-analysis [J]. Neurosci Biobehav Rev, 2017, 72: 87-94.
[33]
Smith KR, Moran TH, Papantoni A, et al. Short-term improvements in cognitive function following vertical sleeve gastrectomy and Roux-en Y gastric bypass: a direct comparison study [J]. Surg Endosc, 2020, 34(5): 2248-2257.
[34]
Ding H, Liu C, Zhang S, et al. Sleeve gastrectomy attenuated diabetes-related cognitive decline in diabetic rats [J]. Front Endocrinol (Lausanne), 2022, 13: 1015819.
[35]
Gunstad J, Strain G, Devlin MJ, et al. Improved memory function 12 weeks after bariatric surgery [J]. Surg Obes Relat Dis, 2011, 7(4): 465-472.
[36]
Alosco ML, Spitznagel MB, Strain G, et al. Improved memory function two years after bariatric surgery [J]. Obesity (Silver Spring), 2014, 22(1): 32-38.
[37]
Smith KR, Steele KE, Papantoni A, et al. The relationship between weight loss and cognitive function in bariatric surgery [J]. Surg Endosc, 2023, 37(3): 1976-1984.
[38]
Li CM, Song JR, Zhao J, et al. The effects of bariatric surgery on cognition in patients with obesity: a systematic review and meta-analysis [J]. Surg Obes Relat Dis, 2022, 18(11): 1323-1338.
[39]
Kelly AS, Ryder JR, Marlatt KL, et al. Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity [J]. Int J Obes (Lond), 2016, 40(2): 275-280.
[40]
Custers E, Franco A, Kiliaan AJ. Bariatric Surgery and Gut-Brain-Axis Driven Alterations in Cognition and Inflammation [J]. J Inflamm Res, 2023, 16: 5495-5514.
[41]
Rehman K, Akash MS. Mechanisms of inflammatory responses and development of insulin resistance: how are they interlinked? [J]. J Biomed Sci, 2016, 23(1): 87.
[42]
Tschoner A, Sturm W, Gelsinger C, et al. Long-term effects of weight loss after bariatric surgery on functional and structural markers of atherosclerosis [J]. Obesity (Silver Spring), 2013, 21(10): 1960-1965.
[43]
Jeon SG, Hong SB, Nam Y, et al. Ghrelin in Alzheimer's disease: Pathologic roles and therapeutic implications [J]. Ageing Res Rev, 2019, 55: 100945.
[44]
李冠亚. 袖状胃切除减重手术调节大脑功能-胃肠激素/菌群机制的研究 [D]. 西安: 西安电子科技大学, 2021.
[45]
Alosco ML, Spitznagel MB, Strain G, et al. Improved serum leptin and ghrelin following bariatric surgery predict better postoperative cognitive function [J]. J Clin Neurol, 2015, 11(1): 48-56.
[46]
Zheng J, Xie Y, Ren L, Qi L, et al. GLP-1 improves the supportive ability of astrocytes to neurons by promoting aerobic glycolysis in Alzheimer's disease [J]. Mol Metab, 2021, 47: 101180.
[47]
Ren W, Chen J, Wang W, et al. Sympathetic nerve-enteroendocrine L cell communication modulates GLP-1 release, brain glucose utilization, and cognitive function [J]. Neuron, 2024, 112(6): 972-990.
[48]
杜靖, 刘丹丹, 刘秀, 等. 肠道菌群在减重手术后的变化及改善代谢的机制 [J]. 中国普外基础与临床杂志, 2023, 30(3): 279-284.
[49]
Dalile B, Van Oudenhove L, Vervliet B, et al. The role of short-chain fatty acids in microbiota-gut-brain communication [J]. Nat Rev Gastroenterol Hepatol, 2019, 16(8): 461-478.
[50]
Su SH, Chen M, Wu YF, et al. Fecal microbiota transplantation and short-chain fatty acids protected against cognitive dysfunction in a rat model of chronic cerebral hypoperfusion [J]. CNS Neurosci Ther, 2023, 29(Suppl 1): 98-114.
[51]
Oikonomou G, Altermatt M, Zhang RW, et al. The Serotonergic Raphe Promote Sleep in Zebrafish and Mice [J]. Neuron, 2019, 103(4): 686-701.
[52]
孟倩倩. 肥胖及减重手术对大脑功能和结构网络拓扑属性影响的神经影像研究 [D]. 西安: 西安电子科技大学, 2019.
[53]
Ding H, Liu C, Zhang S, et al. Sleeve gastrectomy attenuated diabetes-related cognitive decline in diabetic rats [J]. Front Endocrinol (Lausanne), 2022, 13: 1015819.
[54]
Saindane AM, Drane DL, Singh A, et al. Neuroimaging correlates of cognitive changes after bariatric surgery [J]. Surg Obes Relat Dis, 2020, 16(1): 119-127.
[1] 向韵, 卢游, 杨凡. 全氟及多氟烷基化合物暴露与儿童肥胖症相关性研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 569-574.
[2] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[3] 孟令凯, 李大勇, 王宁, 王桂明, 张炳南, 李若彤, 潘立峰. 袖状胃切除术对肥胖伴2型糖尿病大鼠的作用及机制研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 638-642.
[4] 李猛, 姜腊, 董磊, 吴情, 贾犇黎. 腹腔镜胃袖状切除术治疗肥胖合并2型糖尿病及脂肪胰的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 554-557.
[5] 杨波, 胡旭, 何金艳, 谢铭. 腹腔镜袖状胃切除术管胃固定研究现状[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 452-455.
[6] 玉素江·图荪托合提, 韩琦, 麦麦提艾力·麦麦提明, 黄旭东, 王浩, 克力木·阿不都热依木, 艾克拜尔·艾力. 腹腔镜袖状胃切除或联合食管裂孔疝修补术对肥胖症合并胃食管反流病的中期疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 501-506.
[7] 刘见, 杨晓波, 何均健, 等. 应用电钩三孔法腹腔镜袖状胃切除术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(06): 363-364.
[8] 谢浩文, 丁建英, 刘小霞, 冯毅, 姚婧. 椎旁神经阻滞对微创胃切除肥胖患者术中血流、术后应激及康复质量的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 569-573.
[9] 唐小久, 胡曼, 许必君, 肖亚. 肥胖合并胃食管反流病患者严重程度与其焦虑抑郁及营养状态的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 360-364.
[10] 王星, 陈园, 热孜万古丽·乌斯曼, 郭艳英. T2DM、Obesity、NASH、PCOS共同致病因素相关的分子机制[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 481-490.
[11] 中国医师协会外科医师分会肥胖代谢病综合管理与护理专家工作组, 中国医师协会外科医师分会肥胖和代谢病外科专家工作组, 中国肥胖代谢外科研究协作组. 肥胖代谢外科医学科普中国专家共识(2024 版)[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 227-234.
[12] 向林, 江云颂, 程吕佳, 关炳生, 杨景哥. 生长素释放肽在肥胖治疗中的潜在应用价值研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 235-241.
[13] 王鹏鹏, 周涵苓, 孟化, 刘宝胤. 减重手术后皮肤松弛的塑形手术现状与展望[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 248-254.
[14] 克地尔牙·马合木提, 胡波, 杨琼, 闫素, 胡岚卿, 高沛沛, 姚恩生. 依达拉奉右莰醇对急性脑梗死后认知功能障碍的疗效观察[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 459-466.
[15] 欧春影, 李晓宾, 郭靖, 朱亮, 许可, 王梦, 安晓雷. 丁苯酞对血管性认知障碍大鼠炎症因子的影响及对认知障碍的改善作用[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 483-487.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?