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• W4387037100 abstract "Background: Severe obesity may be accompanied by cognitive dysfunction and non-alcoholic fatty liver disease (NAFLD), but the associations remain unclear. We describe the prevalence of cognitive dysfunction, which cognitive domains are involved, and we examined the associations between cognitive dysfunction and the presence and severity of NAFLD and the associations between cognitive dysfunction and signs of other obesity-related comorbidities including neuronal damage. Methods: A cross-sectional study of patients with a body mass index ≥of 35 kg/m under evaluation for bariatric surgery. They were screened for adiposity related comorbidity and underwent a liver biopsy and basic cognitive testing (n=180) with the Continuous Reaction Time test, the Portosystemic Encephalopathy-Syndrome test, and the Stroop Test. A representative sub-group (n=63) also underwent the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The primary study outcome was 'cognitive impairment', defined as ≥2 abnormal basic cognitive tests and/or an abnormal RBANS. The Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) served as biomarker for neuronal damage. Results: We included 180 patients; 72% were women, age 46 ± 12 years, 78% had NAFLD, and 30% with NASH without cirrhosis. Eight percent were cognitively impaired by the basic tests, and a further 41% by including RBANS (Figure 1). Most impaired were executive and short time memory functions. There were no associations between cognitive impairment and BMI, NAFLD presence or severity, or metabolic comorbidities (Table 1). Male sex (OR 3.67, 95% CI 1.32–10.27) and the use of 2 or more psychoactive medications (5.24, 95% CI 1.34–20.4) were associated with impairment. TREM2 was not associated with cognitive impairment. Conclusion: Nearly half of this severely obese study cohort exhibited measurable multi-domain cognitive impairment. This was not dependent on NAFLD or another adiposity comorbidity.Figure 1.: Results from cognitive testing. All (n=180) underwent basic tests, which included continuous reaction time (CRT), Portosystemic Encephalopathy-Syndrome test (PSE), and Stroop EncephalApp. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was available in 63 representative participants. Table 1. - Results from multivariable logistic regression analysis. We applied backward selection, removing terms with p>0.2 and adding those with P<0.1. Sex, age, education, ammonium, sleep apnea, hypertension, severe fibrosis, and psychoactive medication and significant variables from the univariable analysis Stepwise multivariable Stepwise multivariable N=180 N=63 Variables OR 95% CI P-value OR 95% CI P-value Sex (Male) 3.67 1.32-10.27 0.013 32.7 2.5-420 0.007 Age (years) 0.96 0.93-1.00 0.051 0.89 0.83-0.97 0.008 Education (years) 0.86 0.72-1.02 0.077 0.69 0.48-1.02 0.065 LDL cholesterol (mmol/L) 0.59 0.37-0.96 0.035 0.34 0.12-0.99 0.049 Psychoactive medication Antidepressants (Yes) 1.99 0.55-7.09 0.288 Antipsychotics 4.9 0.36-65.7 0.230 Pain medication, narcotics (Yes) 2.67 0.55-12.9 0.222 > of the above groups 5.24 1.34-20.4 0.017 Steatohepatitis, NASH (Yes) Severe fibrosis, F3-4 (Yes) 2.95 0.60-14.3 0.181 0.04 0.001-1.64 0.090 Ammonia ion (umol/L) 0.89 0.79-1.00 0.052" @default.
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• W4387037100 date "2023-09-01" @default.
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• W4387037100 title "P47 Cognitive Impairment in Obesity and NAFLD: A Cross-Sectional Study of 180 Patients With Multi-Domaine Cognitive Testing and Liver Biopsy" @default.
• W4387037100 doi "https://doi.org/10.14309/01.ajg.0000948472.50838.bd" @default.
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