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- 저자 : Michael L. Alosco (검색결과 1 건)
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Michael L. Alosco,Mary Beth Spitznagel,Gladys Strain,Michael Devlin,Ronald Cohen,Ross D. Crosby,James E. Mitchell,John Gunstad 대한신경과학회 2015 Journal of Clinical Neurology Vol.11 No.1
Background and Purpose Bariatric surgery is associated with improved cognitive function,but the mechanisms underlying these gains remain poorly understood. Disturbed leptin andghrelin systems are common in obese individuals and are associated with impaired cognitivefunction in other samples. Bariatric surgery has been shown to improve serum leptin and ghrelinlevels, and these changes may underlie postoperative cognitive improvements. Methods Eighty-four patients completed a computerized cognitive test battery prior to bariatric surgery and at 12 months postoperatively. Participants also submitted to an 8-hour fastingblood draw to quantify serum leptin and ghrelin concentrations at these same time points. Results Baseline cognitive impairments and disturbed leptin and ghrelin levels improved atthe 12-month follow-up compared to presurgery. Higher leptin levels were associated withworse attention/executive function at baseline; no such findings emerged for ghrelin. Regressionanalyses controlling for baseline factors and demographic characteristics showed that both decreased leptin and increased ghrelin following surgery was associated with better attention/executive function at the 12-month follow-up. These effects diminished after controlling for the postoperative change in body mass index (BMI); however, BMI change did not predict 12-month cognitive function. Conclusions Improvements in leptin and ghrelin levels following bariatric surgery appear to contribute to postoperative cognitive benefits. These gains may involve multiple mechanisms, such as reduced inflammation and improved glycemic control. Future studies that employ neuroimaging are needed to clarify the underlying mechanisms and determine whether the effects of bariatric surgery on leptin and ghrelin levels can attenuate adverse brain changes and/or risk of dementia in severely obese individuals.
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