综述与专论: 减重手术改善肥胖症认知功能障碍及其机制
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作者单位:

1)宁波大学附属第一医院,宁波 315000;2)宁波大学医学部基础医学院,宁波 315211

作者简介:

Tel: 0574-87609589, E-mail: wangzhengchun@nbu. edu. cnTel: 86-574-87609589, E-mail: wangzhengchun@nbu.edu.cn

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基金项目:

宁波市自然科学基金(202003N4236),浙江省自然科学基金 (LY21C090001,LGF21C010001),宁波市科技计划(2022S027), 国家自然科学基金(31800874) 和宁波大学王宽诚幸福基金资助 项目。


Review: Bariatric Surgery Alleviates Cognitive Dysfunctions Associated With Obesity Through Multi Mechanisms
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Affiliation:

1)The First Affiliated Hospital of Ningbo University, Ningbo 315000, China;2)School of Basic Medical Sciences, Health Science Center, Ningbo University, Ningbo 315211, China

Fund Project:

This work was supported by grants from Ningbo Natural Science Foundation (202003N4236), Natural Science Foundation of Zhejiang Province (LY21C090001, LGF21C010001), Ningbo Science and Technology Plan Project (2022S027), The National Natural Science Foundation of China (31800874), and the K. C. Wong Magna Fund in Ningbo University.

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    摘要:

    越来越多的证据表明,肥胖会对大脑功能和结构产生负面影响。肥胖个体在食物线索、味觉和嗅觉、静息状态活动和功能连接方面显示出异常的神经反应,同时在决策、抑制控制、学习、记忆和注意力等认知任务中表现出异常。减重手术作为一种专门的治疗方案,可以改变消化系统解剖和生理机制,从而限制食物摄入或改变营养吸收来实现短期和长期的减重效果,改善并发症,降低死亡率,并提高生活质量。最近的研究表明,减重手术对改善肥胖症相关的认知功能障碍具有积极的影响。本文概述了肥胖与认知功能之间的关联,并重点阐述了近年来减重手术改善肥胖相关认知损伤的研究进展。涉及的内容包括奖励处理、食物摄入控制、大脑区域对认知功能的调控、大脑结构异常的恢复、激素调节改变以及对肠道微生物组成的改变,这些变化可能会影响脑功能和认知过程,这些研究成果有望为改善肥胖症患者的认知功能提供新的治疗策略和临床指导。

    Abstract:

    Growing evidence suggests that obesity has negative effects on brain function and structure. Obese individuals exhibit abnormal neural responses in relation to food cues, taste and smell, resting-state activity, and functional connectivity. They also demonstrate impairments in cognitive tasks such as decision-making, inhibitory control, learning and memory, and attention. Bariatric surgery, as a specialized treatment approach, can alter the anatomy and physiological mechanisms of the digestive system, thereby restricting food intake or modifying nutrient absorption to achieve short-term and long-term weight loss effects. It can also improve complications, reduce mortality rates, and enhance quality of life. Recent studies have shown that bariatric surgery has a positive effect on improving obesity-related cognitive dysfunction. This article provides an overview of the association between obesity and cognitive function and focuses on the research progress in recent years regarding the improvement of obesity-related cognitive impairments through bariatric surgery. Several mechanisms may be involved in bariatric surgery to improve obesity-related cognitive dysfunction. Potential mechanisms include weight loss, altered hormone regulation (e.g., ghrelin, leptin), improved insulin sensitivity, reduced systemic inflammation, and changes in gut microbiota. The relationship between bariatric surgery and cognition is complex and multifactorial, and the exact mechanisms are still being explored. Effects of obesity-related complications, hormonal changes, gut-brain-axis, inflammation, brain structure, and nutritional factors on cognitive function after bariatric surgery were discussed. Identifying these mechanisms could help uncover new targets for intervention and provide a basis for optimizing patient outcomes in terms of weight loss and cognitive function.

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杨斌,张丽芝,陈琦芳,朱熙照,王正春.综述与专论: 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

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历史
  • 收稿日期:2023-06-26
  • 最后修改日期:2023-08-03
  • 接受日期:2023-08-13
  • 在线发布日期: 2023-10-20
  • 出版日期: 2023-10-20